Long-term apical bone gain after implant placement combined with internal sinus-floor elevation without graft

Peter Rammelsberg,Andreas Zenthöfer,Julia Pahle,Christopher Büsch

doi:10.1186/s12903-020-01178-4

Abstract

BackgroundTo assess changes in apical bone height/bone gain over up to 8 years after implant placement combined with simultaneous internal sinus-floor elevation (ISFE) without use of graft.Methods217 implants were placed in combination with graft-free ISFE and successfully healed in the posterior maxilla of 138 patients. Radiographs after surgery across an evaluation time of up to 8 years were analyzed. Changes in apical and marginal bone height related to the implants were measured. Differences in bone height over the study period were evaluated by use of Wilcoxon tests. To identify possible influencing factors on apical bone gain and marginal bone loss, backward linear regression variable selections and linear mixed regression models were performed.ResultsAt the apical aspects of the implants, significant mean vertical bone gain of 2.4 mm (mesial) and 2.6 mm (distal) was observed after 6 months (p < 0.05). Radiographic analysis yielded additional bone gain of up to approximately 3.5 mm over the study period. Small initial bone height was crossed with more pronounced apical bone gain (p < 0.05).ConclusionsIf implants are placed combined with graft-free ISFE, significant vertical bone gain, especially in the first year post-op, can be expected. Smaller initial bone height is associated with a higher likelihood for greater bone gain.

Highlights

To assess changes in apical bone height/bone gain over up to 8 years after implant placement combined with simultaneous internal sinus-floor elevation (ISFE) without use of graft
With regard to implant prognosis, the authors of this study reported that residual bone heights lower than 4 mm and membrane perforations reduce the probability of 10-year survival [17]
Of 225 tissue-level implants initially placed in combination with simultaneous internal sinus-floor elevation without graft, 217 implants were considered for the radiographic analysis

Summary

Introduction

To assess changes in apical bone height/bone gain over up to 8 years after implant placement combined with simultaneous internal sinus-floor elevation (ISFE) without use of graft. Boyne et al [1] and Tatum [2] described a technique for sinus floor elevation including a lateral window access to the sinus floor and manipulation of graft material below the Schneiderian membrane in order to increase bone. The internal / transcrestal sinus-floor elevation (ISFE), introduced by Summers [4], is a less invasive approach. Instead of the lateral window, sinus floor is accessed through the drill hole generated by use of a pilot drill. The Summers technique has been recommended as a predictable alternative for implant placement in maxillary bone of at least 6 mm in height [5].

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Conclusion