Search

Background: Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable with those placed in non-augmented sites. Flapless implant surgery can minimize postoperative morbidity, alveolar bone resorption and crestal bone loss. The use of cone beam computerized tomography (CBCT) provides 3D presentations with reduced dose exposure. Objectives: To evaluate a flapless, CBCT-guided transalveolar sinus floor elevation technique with simultaneous implant installation. Material and methods: Fourteen consecutive patients in need of maxillary sinus floor augmentation were enrolled in this study. Preoperative CBCT with a titanium screwpost as an indicator at the intended implant position was used to visually guide the flapless surgical procedure. Twenty one implants all with a length of 10 mm and a diameter of 4.1 and 4.8 mm were inserted and followed clinically and with CBCT for 3, 6 and 12 months postoperatively. Intraoral radiographs were taken for comparison. All patients were provided with permanent prosthetic constructions 8-12 weeks after implant surgery. Results: Ten (47.6%) implants were inserted in residual bone of 2.6-4.9 mm and 11 (52.3%) implants were inserted in residual bone of 5-8.9 mm. No implants were lost after surgery and follow-up. There was no marginal bone loss during the follow-up verified by CBCT. The implants penetrated on average 4.4 mm (SD 2.1 mm) into the sinus cavity and the mean bone gain was 3 mm (SD 2.1 mm). Conclusion: Flapless transalveolar sinus lift procedures visually guided by preoperative CBCT can successfully be used to enable placement, successful healing and loading of one to three implants in residual bone height of 2.6-8.9 mm. There was no marginal bone loss during the 3-12 months follow-up. To cite this article: Fornell J, Johansson L-Å, Bolin A, Isaksson S, Sennerby L. Flapless, CBCT-guided osteotome sinus floor elevation with simultaneous implant installation. I: radiographic examination and surgical technique. A prospective 1-year follow-up. Clin. Oral Impl. Res. 23, 2012; 28-34. doi: 10.1111/j.1600-0501.2010.02151.x [ABSTRACT FROM AUTHOR]

In a randomized prospective study, two implant systems were compared in forty consecutive patients treated for mandibular edentulism. The patients were randomly allotted for treatment by the Brånemark[sup ®] two-stage (submerged) system (BRS), or the ITI[sup ®] one-stage (non-submerged) system. In all, 102 Brånemark selftapping implants and 106 ITI hollow screw implants were installed and all patients were treated with full bridges. Biological and prosthodontic parameters, complications, success rates, clinical efficacy, patient satisfaction and resource requirements were evaluated. No differences were found in plaque accumulation, bleeding or complications during the follow-up period. The BRS group showed deeper periimplant sulcus, less attached mucosa, larger bridge-mucosa distance and higher Periotest values. Prosthetic complications were not related to the configuration of the implant systems. After 3 years, the cumulative success rates were 97.9% and 96.8% for the Brånemark and ITI systems, respectively (difference not statistically significant). One implant in the BRS group had failed to osseointegrate at the time of abutment connection, and another was lost after 2 years due to progressive breakdown of bone. In the ITI group, three implants showed progressive bone loss after 1–3 years associated with periimplant infection. All 40 bridges were intact and remained stable throughout the study. There was general patient satisfaction, but about half the Brånemark patients reported difficulty in coping with the surgical procedures. Treatment time was similar for the two systems. It is concluded that both systems meet the current requirements for dental implant systems in the treatment of mandibular edentulism. [ABSTRACT FROM AUTHOR]