Patient-Reported Outcome Measures (PROMs) for Two Implant Placement Techniques in Sinus Region (Bone Graft versus Computer-Aided Implant Surgery): A Randomized Prospective Trial.

Ghazwan Almahrous,Sandra David-Tchouda,Nathalie Rancon,Thomas Fortin,Jean-Luc Bosson,Aboubacar Sissoko

doi:10.3390/ijerph17092990

Abstract

Purpose: To assess patient-reported outcomes measures (PROMs) for two implant placement techniques in cases of sinus bone atrophy (bone graft surgery (BGS) versus computer-aided implant surgery (CAIS)), after surgery and one year later, and to evaluate the clinical success of both treatments. Methods: Sixty patients with bone atrophy in the posterior maxilla and in need of implant placement were randomly assigned to two groups, and in accordance with the case report form (CRF), 30 were treated with BGS and 30 with CAIS. Immediately after treatment and one year later, PROMs were assessed, and the clinical success of both treatments was evaluated. Results: No significant differences were found between BGS and CAIS with regard to the following: loss of implants (p = 492); patient recommendation (p = 210); duration of surgery (p = 987); pain on the intervention day (p = 512); pain in the week after intervention (p = 299); and complications in the stage of surgery (p = 1.00). Similarly, at one year, no differences were found with regard to the following: pain around implant (p = 481); infection of implants (p = 491); abnormal radiographic imaging (p = 226); occurrence of undesirable events (p = 1.00); loss of one of the implants (p = 1.00); plaque detection (p = 1.00); bleeding on probing (p = 236); and presence of keratinized mucosa (p = 226). However, a significant difference was found among BGS and CAIS with regard to the number of consultations (p = 0001); number of implants placed (p = 033); and treatment difficulty (p = 0369). Significant differences were found for peri-implantitis (p = 0481) and radiology of craterization (p = 020) in clinical examination at the first year. Conclusion: Treatment difficulty and number of consultations were higher for BGS than for CAIS, as well as peri-implantitis and bone craterization at one year, indicating significant differences between the two treatments. However, there were no statistically significant differences between BGS and CAIS regarding the other PROMs, at placement and after one year.

Highlights

The digital revolution has deeply transformed the world of dentistry
Two treatment techniques were allocated within the SINIMAGE study, the first by sinus lift and bone graft surgery (BGS) and the second by computer-aided implant surgery (CAIS)
Second stage: 27 patients had placed 75 implants in the second stage; one patient asked to be removed from the study and one patient was removed from the study after his bone graft failed and the implants were placed by CAIS

Summary

Introduction

The digital revolution has deeply transformed the world of dentistry. The introduction of novel devices such as intraoral [1], desktop [2], and face scanners [3]; computer-assisted design/computerassisted manufacturing (CAD/CAM) software [4]; milling units [5]; and 3D printers [6], together with new materials [7,8], has changed the face of dentistry.Cone beam computed tomography (CBCT) has a deep impact in the implant dentistry because it allows the clinician to capture 3D information of the available bone for a better treatment planning, with considerably reduced radiations to the patient [9]; CBCT opens the door to computer-aided implant surgery (CAIS), which is nowadays one of the most important applications of digital dentistry [10].Since of the first publication on image-guided surgery [11], many applications have been proposed to planimplant placement in advance. The digital revolution has deeply transformed the world of dentistry. Cone beam computed tomography (CBCT) has a deep impact in the implant dentistry because it allows the clinician to capture 3D information of the available bone for a better treatment planning, with considerably reduced radiations to the patient [9]; CBCT opens the door to computer-aided implant surgery (CAIS), which is nowadays one of the most important applications of digital dentistry [10]. Sinus atrophy is an anatomical obstacle and prevents the placement of implants of adequate length. It is of great importance that this obstacle be removed using adequate surgical procedures, with these procedures aimed at reducing the expanded volume of this cavity either partially or totally [13]

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Conclusion