Inlay osteotome sinus floor elevation with concentrated growth factor application and simultaneous short implant placement in severely atrophic maxilla.

Yonghui Chen,Dong Wu,Shuxin Hong,Dingguo Zheng,Yiwei Lai,Pei Lin,Yahua Cai,Zhiyu Cai

doi:10.1038/srep27348

Abstract

Sinus floor elevation with simultaneous implant placement in severely atrophic maxilla is challenging. The aim of this retrospective study was to evaluate the short-term performance of modified osteotome sinus floor elevation (OSFE) with concentrated growth factor (CGF) application and concurrent placement of a short implant in cases with residual bone height (RBH) of 2–4 mm. Twenty-five short implants were installed in 16 patients with mean RBH of 3.23 mm using modified OSFE with CGFs from January 2012 to April 2014. Postoperatively, the implants were clinically evaluated, and vertical bone gain (VBG) was measured using cone beam computed tomography. The mean duration of follow-up was 19.88 months (12–32 months). All the implants were stable with an overall survival rate of 100%. The mean VBG immediately after surgery was 9.21 mm. Six months later, significant reduction of alveolar bone height (2.90 ± 0.22 mm) was found (P < 0.05). During the second 6-month period, further alveolar bone resorption (0.14 ± 0.11 mm) was noted but without significance (P > 0.05). Within the limits of this study, modified OSFE with CGF application and simultaneous short implant placement could yield predictable clinical results for severely atrophic maxilla with RBH of 2–4 mm.

Highlights

In which the residual alveolar bone height (RBH) ranges from 4 to 6 mm[6,7]
In a multicentre study to compare the performance of implant placement using the osteotome sinus floor elevation (OSFE) technique in patients with RBH ≤4 mm and RBH >4 mm, no significant difference was observed in terms of success rate or peri-implant bone loss[10]
A retrospective cohort study reported that short implants 6 mm in length in the maxillary posterior area could only achieve a survival rate of 87%17, most other long-term studies with up to 10 years of follow-up have shown that short implants in the posterior maxilla could obtain satisfying clinical outcomes[18,19]

Summary

Introduction

In which the RBH ranges from 4 to 6 mm[6,7]. For cases with RBH no greater than 4 mm, a few authors have reported successful results of OSFE8–10. In a multicentre study to compare the performance of implant placement using the OSFE technique in patients with RBH ≤4 mm and RBH >4 mm, no significant difference was observed in terms of success rate or peri-implant bone loss[10]. To date, there have been no reports of the performance of OSFE using CGFs as the grafting material with immediate short implant placement in cases with RBH between 2 and 4 mm. The aim of this retrospective study was to investigate whether the proposed protocol could be a feasible therapy strategy for severely atrophic maxillae with RBHs ranging from 2 to 4 mm

Methods

Results

Conclusion