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Objective: To compare implant stability and clinical outcome in implant placement between osteotome sinus floor elevation (OSFE) with biphasic calcium phosphate (BCP) which consisted of 30% of hydroxyapatite (HA) and 70% of beta-tricalcium phosphate (β -TCP) grafting material and OSFE without using bone grafting material. The research questions is whether the BCP provides any benefit in OSFE or not. Materials and methods: Thirty patients (30 implants) with a single edentulous area of upper premolar or molar were randomly separated into OSFE with BCP (n = 15) and OSFE without grafting (n = 15). The patients were reevaluated 3, 6, 9, and 12 months after implant loading. The clinical assessments (implant stability quotient (ISQ), implant survival-failure rate, and surgical complication) were analyzed. Together with radiographic assessments in 2D (endo-sinus bone gain (ESBG), mean marginal bone change (MMBC)) and 3D (endo-sinus bone gain in CBCT (ESBG-CT)) were evaluated, with a mean follow-up time of at least 12 months of functional loading and prosthetic complication. Results: 20 remaining implants (OSFE with BCP, n = 10; OSFE without grafting, n = 10) were analyzed. Mean ISQ was 79.18 ± 3.43 in 1-year follow-up (ISQ; OSFE with BCP = 78.72 ± 3.46, OSFE without grafting = 79.65 ± 3.52). ISQ in both groups increased steadily without significant differences in each follow-up. (p = 0.56). In radiographic evaluation, at 6-, 9-, and 12-month, OSFE without grafting group showed statistically significant lower MMBC (p < 0.05). The 1-year clinical results showed that 2 implants failed in OSFE with BCP, and 1 implant failed in OSFE without grafting. Conclusions: Graft material “BCP” (HA30:TCP70) coupled with OSFE presents no extraordinary benefit in implant stability, clinical and radiographic outcome in 1-year follow-up. Clinical relevance: Clinically, OSFE with grafting materials provides no additional benefit. Clinical trial registration number: TCTR20210517008 (date of registration: May 17, 2021) [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to identify the highly cited references that drove the research on implant dentistry with CBCT. Materials and Methods: The literature database Web of Science Core Collection was accessed to identify a collection of papers on this theme. Cited reference analysis was conducted with the aid of CRExplorer, dedicated bibliometric software. Results: The analysis succeeded in identifying the papers that introduced the very first CBCT machines in the Asian and European markets, respectively; papers that proved the CBCT measurement accuracy, its ability to visualize sinus floor penetration, and its reduced metal artifact relative to conventional CT; papers that gave imaging guidelines for implant cases; and papers reporting bone remodeling at extraction sockets and the possibility of grafting at sites with inadequate bone. Conclusion: These publications together provided solid evidence to support subsequent dental implant research and evaluation by CBCT. [ABSTRACT FROM AUTHOR]

The size and the position of the sinus antrostomy play a key role in making sinus grafting surgery more predictable and effective with less complications. A cone beam computed tomography and intraoral scan of the maxilla were taken for a patient who is missing maxillary first molar tooth with limited residual bone. Data were exported to the dynamic navigation (DN) system software. Sinus lateral window osteotomy position and dimensions were determined and planned using four 1.5 mm diameter implants placed on the maxillary sinus lateral wall. The osteotomy was initiated following the planned four 1.5 mm implants in a parallel motion to the bone surface using dynamic navigation guidance; thus, creating an outline for the lateral sinus window. Afterword's, the lateral sinus window was greenstick fractured and the membrane was lifted; first molar implant osteotomy done, implant placed, and bone graft material was placed. The flap was sutured, and post-operative instructions and medications were given. No post-operative complications noticed. The outline of the lateral window osteotomy along with implant osteotomy can be accurately planned and executed using DN technology, which may potentially reduce complications and insure accurate placement of the implant and the graft. [ABSTRACT FROM AUTHOR]

Maxillary sinus lift surgery is applied to compensate for the reduced vertical height in the posterior maxilla to facilitate placing a dental implant of a suitable length. Pathological conditions may be accidentally discovered, which necessitate careful assessment and management to prevent the infection of the maxillofacial complex and eventually bone grafting and dental implant failure. This case report describes an approach for the management of Schneiderian membrane perforation associated with the removal of an antral pseudocyst for successful dental implant therapy. A 70-year-old healthy Caucasian male presented for implant therapy to replace a non-restorable maxillary molar. Initial examination revealed the need for a sinus lift procedure to prepare the site for implant placement. A 3D CBCT evaluation before surgery revealed an incidental finding of a pathological lesion at the surgical site. The histological analysis of a biopsy specimen retrieved during implant site preparation showed findings consistent with antral pseudocyst. The resulting perforation of the sinus membrane was treated, and an adequate period of healing was given. A thickened sinus membrane was detected upon surgical exposure for implant placement. The novel technique illustrated could result in a fibrotic repaired sinus membrane and help shorten the time required for dental implant treatment. [ABSTRACT FROM AUTHOR]

This article reviews the optimal management of oroantral fistulas, implants protruding into the maxillary sinus, implants completely displaced into the sinus(es), and infected bone grafts used for sinus augmentation. For each scenario, multidisciplinary management strategies will be considered based on whether there is concurrent infectious odontogenic sinusitis. A multidisciplinary approach with oral surgeons and otolaryngologists is often mandatory to ensure optimal therapeutic outcomes., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Sinus lifts is a procedure often used in the last four decades. Posterior atrophic maxilla with pneumatized sinus often challenges dental implant surgery. Sinus lift in order to augment the residual alveolar ridge height resulted in various sinus lift surgical techniques. Sinus augmentation in atrophic maxilla transforms the atrophic posterior maxilla to a favorable place for implant placement. The primary method of long-term evaluation of sinus grafts has been evaluated based on the implant survival. Implant placed with sinus lift grafts had shown superior results than those placed without grafts. Lateral window method (direct technique) offers the best visualization of the sinus membrane. Particulate grafts used should has osteoinductive or osteoconductive properties and to help in long-term volume maintenance. Within the limits of this study, we can say that the primary method of long-term evaluation of sinus grafts has been evaluated based on the implant survival. Implant placed with sinus lift grafts had shown superior results than those placed without grafts.

Maxillary sinus lift surgery is applied to compensate for the reduced vertical height in the posterior maxilla to facilitate placing a dental implant of a suitable length. Pathological conditions may be accidentally discovered, which necessitate careful assessment and management to prevent the infection of the maxillofacial complex and eventually bone grafting and dental implant failure. This case report describes an approach for the management of Schneiderian membrane perforation associated with the removal of an antral pseudocyst for successful dental implant therapy. A 70-year-old healthy Caucasian male presented for implant therapy to replace a non-restorable maxillary molar. Initial examination revealed the need for a sinus lift procedure to prepare the site for implant placement. A 3D CBCT evaluation before surgery revealed an incidental finding of a pathological lesion at the surgical site. The histological analysis of a biopsy specimen retrieved during implant site preparation showed findings consistent with antral pseudocyst. The resulting perforation of the sinus membrane was treated, and an adequate period of healing was given. A thickened sinus membrane was detected upon surgical exposure for implant placement. The novel technique illustrated could result in a fibrotic repaired sinus membrane and help shorten the time required for dental implant treatment.

This study sought to determine the rate of sinus membrane perforation in patients undergoing crestal sinus grafting, as well as the effect of Schneiderian membrane thickness and residual bone height (RBH) on membrane perforation, using cone beam computed tomography. The study included 25 patients undergoing 44 crestal sinus grafting procedures. The sites for crestal sinus grafting were divided into a control group (RBH ≥ 5 mm) and a test group (RBH < 5 mm). All sinus grafting procedures were also categorised based on membrane thickness: group A (<1 mm), group B (1–2 mm), and group C (≥2 mm). The rate of membrane perforation was 18.2%. The median RBH measurement was 5.59 mm. No statistically significant difference in membrane perforation rate was found between the test and control groups (P = 0.262). The median thickness of the Schneiderian membrane was 1.35 mm. There was no statistically significant difference in membrane perforation among the three membrane thickness groups (P = 0.431). No significant correlation between RBH and membrane perforation was observed, although clinical observation indicated that there was a tendency for an increased membrane perforation rate in the presence of a RBH < 5 mm. The perforation rate was found to be at its highest when the membrane was thinner than 1 mm. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate long‐term clinical and radiographic outcomes of dental implants placed after lateral window sinus augmentation utilizing the sagittal sandwich technique. Materials and Methods: Patients treated with sinus augmentation were included in this retrospective case‐series study. The surgical procedure was performed with particulate autogenous bone‐ and anorganic bovine bone‐derived mineral (3:7 ratio). Implants were grouped based on baseline residual alveolar ridge height: group S (residual alveolar ridge height of 0.1–3.5 mm), group M (height of 3.5‐7mm), and group C (native bone). Radiographs were taken at baseline (abutment installation) and annually throughout the 10‐year follow‐up. Results: A total of 86 patients (92 sinus lifts) and 209 implants were included. Ten sinus membrane perforations were recorded (11% incidence), and graft infections occurred in 3 cases (3.2% incidence). During the 10‐year follow‐up, 3 implants (1.4%) failed. No significant differences in the mean implant marginal bone loss (MBL) between the three groups were found after 1‐, 2‐, and 5‐year follow‐up (p >.05). At 10 years, group C exhibited more MBL than group M with a mean difference of −0.53 mm (p =.01). After 10 years, MK III implants displayed significantly more bone loss in native bone than those in augmented bone with a mean difference of 0.48 mm (p =.02). Five patients and 7 implants developed peri‐implantitis with no significant differences between the groups (p =.570). Conclusion: Implant placement after two‐stage sinus grafting utilizing the sagittal sandwich technique is a relatively safe and predictable procedure with minimal complications and MBL after 10‐year follow‐up. [ABSTRACT FROM AUTHOR]

After tooth loss in the posterior area of the maxilla, sinus floor elevation is often required to compensate the vertical bone loss due to sinus pneumatization. This narrative review reports on the potential benefits of autologous platelet concentrates (APCs) during this procedure. As for transcrestal approach, APCs have been used as "sole" substitute/graft. However, because of the low number of clinical trials available with PRGF, and even none for PRP, no definitive conclusions can be made regarding their efficacy. The number of studies on the use of L-PRF were outnumbered indicating good feasibility for vertical bone gain, with a high implant survival rate and a low degree of complications. PRP and PRGF have not been studied as a "single/sole" substitute for a one-stage lateral window approach, probably because of the weak physical characteristics of the membranes. L-PRF alone appears to be a predictable grafting material for lateral maxillary sinus grafting and a reduced RBH should not be considered as a risk factor. Compared to a "standard" bone substitute L-PRF shows slightly less vertical bone gain (consider enough membrane application and use of bony window as new sinus floor roof over the implant apices), enhanced early resorption (first 6 months after application), but a similar stable bone gain afterward. For a two-stage lateral window approach, APCs "alone" cannot be recommended, due to their weak withstand to the sinus pneumatization forces. APCs combined with bone substitutes seem to accelerate bone formation, without any additional benefits on the long-term new bone gain. The use of L-PRF membranes for the treatment of perforations appears to be an effective treatment option, but further clinical studies are needed to confirm this. Even though the abovementioned statements are based on large numbers of studies, additional RCTs comparing APCs with different types of grafting procedures for sinus elevation are needed., (© 2024 The Authors. Periodontology 2000 published by John Wiley & Sons Ltd.)

Purpose: The objective of this study was to evaluate sinus floor augmentation with simultaneous implant placement using platelet-rich fibrin (PRF) as the only grafting material. Materials and Methods: This study included patients who underwent sinus floor augmentation with simultaneous implant placement using PRF as the sole filling material between July 2009 and January 2011 at the Department of Oral and Maxillofacial Surgery, Nagasaki University Hospital. For each patient, presurgical and postsurgical (6 months after the surgery) radiography and computed tomographic scanning were performed to assess bone formation at the implant sites. The density (in Hounsfield units [HU]) of the newly formed bone and the bone height from the sinus floor to the alveolar crest where implants were inserted were measured using implant planning software (Simplant, Materialise Dental). Results: Nine sinus floor augmentations were performed, and 17 implants were placed in six patients. The mean residual bone height between the sinus floor and alveolar crest was 4.28 ± 1.00 mm (range, 1.9 to 6.1 mm) prior to surgery and 11.8 ± 1.67 mm (range, 9.1 to 14.1 mm) after surgery. The alveolar bone ridge was wide enough for implant placement in all cases. The mean density of the newly gained bone around the implants was 323 ± 156.2 HU (range, 185 to 713 HU). All implants were clinically stable at the time of abutment insertion, 6 months after sinus augmentation. Conclusion: Sinus elevation with simultaneous implant placement using PRF as the only filling material may promote natural bone regeneration. [ABSTRACT FROM AUTHOR]

Aims: To assess the long‐term clinical and radiographic results of implants placed using osteotome sinus floor elevation (OSFE) with or without bone grafting. Materials and methods: Forty‐five patients were randomly assigned into two groups: Group 1 (OSFE with deproteinized bovine bone mineral) and Group 2 (OSFE without grafting). The patients were recalled at 1, 3, 5 and 10 years after surgery. The implant survival, endo‐sinus bone gain (ESBG), marginal bone loss (MBL), peri‐implant bone height (PBH, distance from the most coronal level to the most apical level of bone‐to‐implant contact), prosthesis survival and hardware complications, and peri‐implant soft tissue conditions were assessed. Results: Forty patients attended the 10‐year examination. Mean residual bone height was 4.58 ± 1.28 mm. The 10‐year cumulative survival rate was 90.7% for Group 1 and 95.0% for Group 2. The PBH was 5.89 ± 1.24 mm for Group 1 and 5.74 ± 1.43 mm for Group 2 at 10 years. The ESBG of both groups remained stable after 3 years. Two‐thirds of the implants were free of hardware complications. No significant differences in MBL and peri‐implant tissue parameters were found. Conclusion: OSFE with or without grafting both yielded predictable clinical outcomes with similar PBH (ClinicalTrials.gov. NCT01619956). [ABSTRACT FROM AUTHOR]

Autogenous bone grafting requires a donor site and may lose substantial volume during remodeling. Several bone replacement materials (BRMs) are under development to overcome these limitations, especially for indications for minimally intervention surgeries. The objective of our study was to assess the potential of an equine collagen cone reinforced with biphasic calcium phosphate (CC‐BCP) particles and deproteinized bovine bone matrix (BBM) coated with polylactic acid, and poly‐ε‐caprolactone copolymer (BBM‐PCC) and then to compare the outcomes with a deproteinized BBM and an equine CC without a filler in a sheep sinus grafting model in the Elleven female sheep were selected. Two experimental sites on each side of the animals were prepared using an extraoral approach for maxillary sinus wall. The four treatments were performed in each animal through a standardized 10‐mm access window. While the BBM access was covered with a collagen membrane, all other sites were closed with an equine collagen membrane. All animals were euthanized after 16 weeks. New bone (NB), residual graft particles, and connective tissue were measured in undemineralized resin‐embedded sections. As a result, one sheep did not survive the surgery. All sites in the remaining 10 sheep healed uneventfully. All CC and BBM‐PCC grafts resorbed and failed to augment the sinuses. BBM and CC‐BCP, in contrast, showed some histologic evidence of NB and surgical site augmentation. The NB fraction in the latter two groups accounted for 10 ± 9 and 4 ± 5%, respectively (p > 0.05). In conclusion, BBM‐PCC and collagen cone performed poorly for sinus floor augmentation, while deproteinised BBM and reinforced collagen cone demonstrated comparable outcomes [ABSTRACT FROM AUTHOR]

Purpose: The aims of this prospective study were to: (1) determine clinical and radiographic success and survival rates of implants placed in a staged procedure after sinus augmentation; and (2) compare the success and survival rate of implants in two patient groups with different ridge height prior to treatment (those with minimal residual crestal bone [< 3.5 mm] below the sinus and those with moderate residual crestal bone [> 3.5 mm]). Materials and Methods: The study used anorganic bovine bone-derived mineral and autogenous bone for the sagittal sandwich bone augmentation technique, a collagen membrane to protect the sinus window, and a staged approach for implant placement; all implants featured an anodized surface. Results: Two hundred forty-five implants were placed in 100 sinus sites (79 patients), and 244 have survived to date. The cumulative success and survival rates of all implants overall at 5 years were 96.5% (SE 2.0%) and 99.6% (SE 0.4%), respectively. The overall success and survival rates at 5 years for implants placed into minimal residual crestal bone were 94.1% (SE 3.4%) and 99.4% (SE 0.6%), respectively. For implants placed into moderate crestal bone, overall success and survival rates were both 100.0% (SE 0.0%). Conclusions: Success of implants placed after sinus augmentation appears similar to implants placed in native bone when a classical submerged implant healing time of 6 months is used. The success and survival rates and crestal bone remodeling of implants placed in minimal residual crestal bone were comparable to those of implants placed in moderate residual crestal bone. [ABSTRACT FROM AUTHOR]

Purpose: Inadvertent perforation of the sinus membrane is a frequent complication encountered during sinus floor elevation (SFE). Different strategies have been described for the prevention or treatment of perforations, with varying results. This paper reports the findings of a preliminary study into the application of a novel nasal suction technique in which negative antral air pressure was used to facilitate the raising of the sinus lining and to reduce the risk of perforations occurring during SFE. Materials and Methods: In 24 consecutive patients, nasal suction was applied through the ipsilateral nostril during SFE. The suction device was attached to a high-flow vacuum regulator that incorporated a suction canister connected to a -10-kPA medical vacuum (-75 mm Hg). Fifteen subjects received unilateral SFE, and six subjects had bilateral staged lateral wall sinus elevation; the remaining three subjects had osteotome sinus floor elevation (three unilateral and one bilateral) with simultaneous implant placement. Results: During SFE, the use of nasal suction facilitated the inversion of the sinus lining around the edges of the lateral access window. This made the sinus lifting easier, as the need for extensive instrumentation was significantly reduced. In three subjects, elevation of the sinus lining occurred spontaneously from the lateral, medial, and inferior surfaces of the antrum when nasal suction was applied. Conclusion: Sinus lifting was facilitated by nasal suction. No perforation of the sinus lining occurred in this series. Controlled clinical trials are being designed to further demonstrate the clinical efficacy of the nasal suction technique in SFE. [ABSTRACT FROM AUTHOR]

The efficacy of transantral endoscopy for the removal of a foreign material from the maxillary sinus has been reported previously. Endoscopy has also been used for removal of dental implants after their displacement into the maxillary sinus either during implant placement or subsequently, during implant integration or loading. This case report describes the removal of a dental implant from the maxillary sinus using a modified transantral endoscopic approach combined with simultaneous grafting of the sinus cavity. [ABSTRACT FROM AUTHOR]

Purpose: To present the long-term results for screw-type implants consecutively placed in the pterygo-maxillary-pyramidal region in the treatment of patients with posterior maxillary edentulism. Materials and Methods: One hundred fiftytwo implants were inserted in 92 partially edentulous patients using cylindric osteotomes as bone-site formers, thus minimizing the use of drills in the bone preparation. Results: The 152 implants placed were loaded for an average of 89.7 ± 30.7 months. There were a total of 8 failures; 6 took place between implant placement and prosthesis delivery (early failures), and 2 failed in following functional loading. The overall survival rate was 94.7%. Discussion: Cylindric osteotomes allow the surgeon to accurately place implants. The use of surgical drilling was minimized, resulting in lowered surgical risk and diminished bone loss. Conclusion: Implant placement in the posterior pterygomaxillary region using cylindric osteotomes for osteotomy preparation resulted in an implant survival rate of 94.7%. [ABSTRACT FROM AUTHOR]

Maxillary sinus grafting procedures are currently the treatment of choice when the alveolar crest of the posterior maxilla is in close approximation to the maxillary sinus. The short-term histologic and radiographic healing following sinus grafting with natural bone mineral (Bio-Oss) in the chimpanzee has been evaluated. We have previously shown by histomorphometric and radiographic analysis that the percentage of vital bone area, the vertical height, and the density of new bone in the maxillary sinus was significantly greater with anorganic bovine bone compared to bovine Type I collagen matrix. The purpose of this in vivo study was to determine the bone mineral density (BMD) of the sinus grafts, the vertical height stability, the vital bone area, and the extent of anorganic bovine bone replacement 18 months postoperatively in 4 maxillary sinuses from 4 different animals. Radiographic analysis of computed tomographic scans taken at 1.5 years revealed an average BMD of 658 mg/mL, which was not significantly different from the values found at 6.5 months. The radiographic vertical height was maintained between the 6.5- and 18-month time points. On average, the grafts were found to have a height of 14 mm. Lateral wall biopsy specimens at 7.5 months were compared to those at 18 months. With the anorganic bovine bone treatment, the percentage of vital bone area increased from 62 ± 3% to 70 ± 7% and the percentage of natural bone mineral area decreased from 19 ± 14% to 6 ± 3%. The bovine Type I collagen matrix vital bone percentage at 7.5 months was 34 ± 21%. These results demonstrate that sinus grafting with anorganic bovine bone maintains radiographic evidence of density and height stability to 1.5 years. In addition, histologic evidence supports the hypothesis that anorganic bovine bone is replaced by vital bone. [ABSTRACT FROM AUTHOR]

Forty-three sites in 16 patients were selected for placement of implants using osteotomes in a single-stage surgical technique. Most sites were treated to enhance bone quality. Sixteen sites in the posterior maxilla had sinus elevation performed in conjunction with implant placement. No soft tissue coverage of the implant cover screw was attempted in either the sinus-elevated or the nonelevated sites. Sinus elevation was significant relative to baseline (mean gain 3.25 mm, P < .01). The implant survival rate was 95.3%. [ABSTRACT FROM AUTHOR]

Objectives: The bucco‐palatal sinus width (SW) appears as relevant factor for graft consolidation after maxillary sinus (MS) floor augmentation. The present study aimed to assess (a) SW at different height levels of posterior teeth, (b) possible factors influencing SW, and (c) whether a simple/meaningful sinus classification based on SW is possible. Methods: The following parameters were recorded on computed tomographies of 76 edentulous and 86 partially edentulous maxillary quadrants displaying 383 tooth sites in total: (a) alveolar ridge height, (b) ‐area, (c) ‐width 2 mm apical to the alveolar crest, (d) ‐width at the sinus floor, and (e) SW and sinus area at a level 2, 4, 6, 8, and 10 mm above the sinus floor. The possible influence of gender, tooth position [i.e., premolar (PM); molar (M)], tooth‐gap extent, and residual alveolar ridge dimensions on SW was assessed. Further, based on percentiles of average values or on the frequency distribution of SW <10, 10–15, or >15 mm, it was attempted to classify the sinus at each given site into narrow, average, or wide. Results: Gender and tooth‐gap extent presented no relevant impact on MS dimensions; however, significant differences were observed among the various tooth positions regarding all evaluated parameters. The lower the residual alveolar ridge, the wider the MS at 4–10 mm height, while the wider the residual alveolar ridge, the wider the MS. Large variation in SW classes among the different height levels within the same tooth position and among tooth positions within the same person was observed, irrespective of the threshold applied. Further, at a MS height of 10 mm at PM1, PM2, M1, and M2, SW was <10 mm in 68%, 33%, 0%, and 7% of the cases, respectively, while in 3%, 21%, 65%, and 57%, respectively, SW was >15 mm. Conclusions: There is a large variation in SW depending on the height level within the sinus and on tooth position, which does not permit a simple/meaningful classification of each sinus as "narrow," "average," or "wide." Nevertheless, narrow sinuses (<10 mm) are rather prevalent in the premolar region, while wide sinuses (>15 mm) in the molar region; further, a wider and shorter residual alveolar ridge is associated with a wider SW. [ABSTRACT FROM AUTHOR]

Aim: To compare the implant survival rate between short dental implants and standard length implants placed in combination with bone grafting at 5 years of loading. Methods: This multicentre study enrolled 101 patients (137 implants) with a posterior maxillary bone height of 5–7 mm. Patients randomly received either short implants (6 mm; GS) or long implants (11–15 mm) with sinus grafting (GG). Six months later, implants were loaded with single crowns and patients re‐examined at 1, 3 and 5 years of loading. Outcomes included: implant survival, marginal bone levels (MBLs), biological and technical parameters and patient‐reported outcome measures (OHIP‐49 = Oral Health Impact Profile). Statistical analysis was performed using a non‐parametric approach. Results: At 5 years, 90 patients (124 implants; GS: 60; GG: 64) were re‐examined (drop‐out rate 10%). Patient‐level implant survival rates were 98.5% (GS; 1 implant failure) and 100% (GG; p = 0.49). Mean MBLs were 0.54 mm ± 0.87 (GS) and 0.46 mm ± 1.00 (GG; p = 0.34). Biological and technical parameters were not significantly different (p > 0.05). Median overall OHIP‐49 scores improved significantly up to 5 years in both groups (GS: p = 0.03; GG: p = 0.00; intergroup comparison p = 0.11). Conclusions: Both treatment modalities were suitable for implant therapy in the atrophied posterior maxilla revealing no differences in terms of survival rates, marginal bone levels (changes), patient‐reported outcomes and technical/biological complications. [ABSTRACT FROM AUTHOR]

Aim: This randomized controlled clinical study focused on graft volume alterations after sinus floor augmentation with a deproteinized bovine bone mineral (DBBM, Geistlich Bio-Oss®), deproteinized porcine bone mineral (DPBM, THE GRAFT®) or a biphasic calcium phosphate (BCP, OSOPIA®)., Material and Methods: 28 patients with edentulous situations in the posterior maxilla with less or equal to 5 mm of residual bone height received a two- staged external sinus grafting procedure with DBBM, DPBM or BCP. CBCT scans were performed prior surgery (CBCT1), directly after surgery (CBCT2) and after a healing period of 4-6 months prior implant placement (CBCT3). CBCT scans were used to analyze volumetric alterations of the sinus grafts by virtual 3D model matching of CBCT1- CBCT2 (situation after sinus grafting) and CBCT1 and CBCT2 (situation prior implant placement)., Results: The volume of the bone graft in the maxillary sinus (volume (VOL%) directly after grafting rated as 100%) was stable after the healing period in the DBBM (VOL%: 103±4%) and the PBBM groups (VOL%: 112± 23) with no statistically significant differences concerning 3D measurements. In the BCP group, the grafted volume declined to 66± 25% (VOL%), statistically inferior to the DBBM and DPBM groups., Conclusion: Concerning bone graft stability/ 25 volume DBBM and DPBM show comparable outcomes. Due to resorption, BCP showed inferior bone graft volume after healing (statistically significant) compared to DBBM and DPBM.

Introduction: Sinus lifts have been around for more than four decades now, and the amount of changes that we have seen in techniques and armamentarium coupled with the advent of newer materials is worth taking note of. Materials and Methods: A complete review of the literature was done since the advent of ways and means to augment the posterior maxilla with a run through of various advantages and disadvantages of the same. Conclusion: In conclusion, we can say that this procedure is today very predictable and offers clinicians a possibility to rehabilitate the posterior maxilla with implant-based solutions. [ABSTRACT FROM AUTHOR]

Aim To test whether the use of short dental implants (6 mm) results in an implant survival rate similar to that with longer implants (11-15 mm) in combination with sinus grafting. Methods This multicentre study enrolled 101 patients with partial edentulism in the posterior maxilla and a remaining bone height of 5-7 mm. Included patients were randomly assigned to receive short implants (6 mm; GS/group short) or long implants (11-15 mm) simultaneously with sinus grafting ( GG/group graft). Six months after implant placement ( IP), implants were loaded with single crowns ( PR) and patients were re-examined yearly thereafter. Assessed outcomes included: implant survival, marginal bone level changes ( MBL), probing pocket depth ( PPD), bleeding on probing (BoP) and plaque accumulation ( PCR) during 3 years of loading as well as recording of any adverse effects. In addition to descriptive statistics, statistical analysis has been performed for the two treatment modalities using a non-parametric approach. Results In 101 patients, 137 implants were placed. At the 3-year follow-up ( FU-3), 94 patients with 129 implants were re-examined. The implant survival rate was 100% in both groups. MBL at FU-3 was 0.45 mm ( GG) and 0.44 mm ( GS) ( p > 0.05). A statistically significant loss of MBL was observed in both GG (−0.43 ± 0.58 mm) and GS (−0.44 ± 0.56 mm) from IP to FU-3, and from PR to FU-3 in GG (−0.25 ± 0.58 mm) but not in GS (−0.1 ± 0.54 mm). PCR and BoP at FU-3 did not show any difference between the groups but for PPD ( p = 0.035). Conclusions Within the limitations of this study, implants with a length of 6 mm as well as longer implants in combination with a lateral sinus lift may be considered as a treatment option provided a residual ridge height of 5-7 mm in the atrophied posterior maxilla is present. [ABSTRACT FROM AUTHOR]

Aim: To compare, clinically and radiographically, short dental implants (6 mm) to long implants (11-15 mm) placed with sinus grafting. Methods: Participants with 5-7 mm of bone height in the posterior maxilla were randomly allocated to receive short implants (GS) or long implants with sinus grafting (GG). Implants were loaded with single crowns 6 months after placement (PR). Patients were re-evaluated 12 months after loading (FU-1). Outcome variables included: Implant survival rate (CSR), marginal bone level alteration (MBL), periodontal probing depth (PPD), bleeding on probing (BoP), plaque control record (PCR) and crown-to-implant ratios (C/I). Statistical analysis was performed using parametric tests. Results: In 97 subjects, 132 implants were re-evaluated at FU-1. The CSR was 100%. The MBL from implant placement (IP) to (PR) was -0.22 ± 0.4 mm for GG and -0.3 ± 0.45 mm for GS (p < 0.001). MBL from IP to FU-1 was -0.37 ± 0.59 mm for GG and -0.22 ± 0.3 mm for GS (p < 0.001). Intergroup comparisons showed non-significant differences for MBL (p > 0.05), PPD (p = 1) and PCR (p = 0.09). BoP was higher in the GS (p = 0.04). The C/I was 0.99 ± 0.17 for GG and 1.86 ± 0.23 for GS (p < 0.001). No correlation was observed between C/I and MBL, (GG: p = 0.13; GS: p = 0.38). Conclusions: Both treatment modalities provided similar outcomes. [ABSTRACT FROM AUTHOR]

Purpose The control of postoperative discomfort may improve the patient's quality of life as well as treatment acceptance. The aim of the present preliminary report was to assess if the use of autologous platelet concentrate during maxillary sinus augmentation may have a favorable impact on pain and other factors related to patient's quality of life in the first week after surgery. Materials and Methods This is an interim report of a randomized single-blind study. Fifteen patients with atrophic edentulous posterior maxilla underwent maxillary sinus augmentation using deproteinized bovine bone matrix ( DBBM) as the grafting material (control group). In other 15 patients (test group), autologous plasma rich in growth factors ( P- PRP) was added to DBBM, then a P- PRP clot was applied to covering the graft before suturing and finally P- PRP was placed over the suture in liquid form. During the first week postsurgery, all patients filled in a questionnaire for evaluation of main symptoms and daily activities. The outcomes of the questionnaires of the two groups were statistically compared. Results In the first days postsurgery, the group using P- PRP reported significantly less pain, swelling, and hematoma, and improved functional activities with respect to the control group. Conclusions The adjunct of P- PRP to the maxillary sinus augmentation procedure produced a beneficial effect to patients' quality of life in the early postsurgical phase. [ABSTRACT FROM AUTHOR]

To evaluate implant stability and histological outcomes after osteotome sinus floor elevation ( OSFE) procedure, and to compare new bone formation and implant osseointegration with and without grafting. Material and methods OSFE with simultaneous implant placement was conducted bilaterally on 6 Labrador dogs. Twenty-four implants were placed. The right side sinus (Group 1) was grafted with biphasic calcium phosphate ( BCP), whereas the left side (Group 2) was left without any grafting materials. The animals were euthanized 8 and 24 weeks after surgery for histological and histomorphometric assessment. Bone-to-implant contact ( BIC%), alveolar bone height ( ABH), bone density ( BD) and grafting material density ( GMD) were measured. The implant stability ( ISQ) was assessed using resonance frequency analysis ( RFA) at implant placement and 1, 2, 4, 8, 12, 24 weeks after surgery. Results Endo-sinus new bone with direct contact to implant surface were observed in two groups at both time points. ABH showed no difference between groups at both time points. BIC% and BD in Group 2 (40.05%, 35.90%) was higher than those in Group 1 (23.30%,25.59%) at 24 weeks. Significant shrinkage of grafting material was seen in Group 1. The GMD in Group 1 at 8 weeks was 24.35%, while it dropped to 19.90% at 24 weeks. The changing pattern of ISQ for both groups were similar. Conclusions Spontaneous new bone formation and better bone-to-implant contact were found for OSFE without grafting. The grafting material application during OSFE procedure showed no advantages in histological results. [ABSTRACT FROM AUTHOR]

Aim To test whether or not the use of short dental implants (6 mm) results in an implant survival rate similar to long implants (11-15 mm) in combination with sinus grafting. Methods This multicentre study enrolled 101 patients with a posterior maxillary bone height of 5-7 mm. Patients randomly received short implants (6 mm) (group short) or long implants (11-15 mm) with sinus grafting (group graft). Six months later, implants were loaded with single crowns and patients re-examined at 1 year of loading. Outcomes included treatment time, price calculations, safety, patient-reported outcome measures ( OHIP-49 = Oral Health Impact Profile) and implant survival. Statistical analysis was performed using a non-parametric approach. Results In 101 patients, 137 implants were placed. Mean surgical time was 52.6 min. (group short) and 74.6 min. (group graft). Mean costs amounted to 941 EUR (group short) and 1946 EUR (group graft). Mean severity scores between suture removal and baseline revealed a statistically significant decrease for most OHIP dimensions in group graft only. At 1 year, 97 patients with 132 implants were re-examined. The implant survival rate was 100%. Conclusions Both treatment modalities can be considered suitable for implant therapy in the atrophied posterior maxilla. Short implants may be more favourable regarding short-term patient morbidity, treatment time and price. [ABSTRACT FROM AUTHOR]

Objective: The present study investigated the efficacy of a biphasic calcium phosphate as a bone grafting material for maxillary sinus augmentation in humans. Materials and methods: Half of the thirty patients selected for sinus augmentation were grafted with biphasic calcium phosphate, whereas the other half were grafted with autogenous bone chips harvested intraorally. After 9 months of healing, bone cores were retrieved from implant sites for histologic and histomorphometric evaluation. Results: The areas augmented with autogenous bone chips showed newly formed bone with a pattern very similar to that of the native area. Histomorphometry demonstrated that the amount of newly formed bone in the autogenous bone group was significantly greater than in the biphasic calcium phosphate group (P < 0.05). In the biphasic calcium phosphate group, less bone formation was observed in the area further away from native bone interface than in the area closer to native bone interface (P < 0.05), whereas no significant differences were observed between both areas in the autogenous group. In both groups, the implant survival rate was 100% with a minimum 1-year follow-up. Conclusion: The data presented in this work confirm the osteoconductive properties of biphasic calcium phosphate, as well as its use in association with maxillary sinus floor augmentation procedures with successful outcomes. [ABSTRACT FROM AUTHOR]

Aims To evaluate the clinical and radiographic results of dental implant placed using osteotome sinus floor elevation ( OSFE) with and without simultaneous grafting. Materials & Methods Forty-five patients were randomly assigned into two groups: Group1: OSFE with deproteinized bovine bone mineral ( DBBM) mixed with autogenous bone chips, and Group2: OSFE without grafting. The endo-sinus bone gain ( ESBG) was assessed on radiographs at 6, 12, 24, 36 months following surgery as primary outcome measurement. Implant survivals and marginal bone loss ( MBL) were assessed as secondary outcome measurements. Results Twenty-one implants in Group1 and 20 implants in Group2 were analysed. The residual bone height ( RBH) was 4.63 ± 1.31 mm in average (4.67 ± 1.18 mm for Group1 and 4.58 ± 1.47 mm for Group2). The 3-year cumulative survival rates of implants were 95.2% for Group1 and 95.0% for Group2. The ESBG in Group1 reduced from 5.66 ± 0.99 mm at 6 months to 3.17 ± 1.95 mm at 36 months, whereas the ESBG in Group2 increased from 2.06 ± 1.01 mm at 6 months to 3.07 ± 1.68 mm at 36 months. The MBL after 3 years was 1.33 ± 0.46 mm in Group1 and 1.38 ± 0.23 mm in Group2. Conclusions OSFE and simultaneous implant installation with and without grafting both resulted in predictable results. The application of grafting materials has no significant advantage in terms of clinical success. [ABSTRACT FROM AUTHOR]

To describe the early healing within the void obtained after the elevation of the sinus mucosa and simultaneous implant installation without the use of any grafting material in monkeys. Implants were installed simultaneously with the elevation of the maxillary sinus using the lateral approach in eight monkeys without the use of grafting material. The healing after 4, 10, 20 and 30 days was evaluated in the area distal to the implants. Paraffin sections were prepared and analyzed using qualitative histological methods. The healing process was initiated by the formation of a coagulum and followed by a provisional matrix and woven bone. Subsequently, a parallel-fiber bone replaced woven bone. The dimension of the elevated area shrank during the healing process. Sprouts of woven bone, present to a moderate extent after 4 days, were more numerous after 10 and 20 days. Newly formed bone originated from the sinus walls and septa, while there was no evidence of participation of the Schneiderian membrane in this process. After 30 days, the window access appeared to be closed by a layer of newly formed trabecular bone. The coagulum that filled the void distal to the implant after simultaneous elevation of the sinus floor gave rise to newly formed bone. However, the void occupied by the coagulum shrank substantially. The Schneiderian membrane did not provide a basis for new bone formation in the early phase of healing. Scala A, Botticelli D, Rangel IG Jr, de Oliveira JA, Okamoto R, Lang NP. Early healing after elevation of the maxillary sinus floor applying a lateral access: a histological study in monkeys. Clin. Oral Impl. Res. , 2010; 1320-1326. doi: 10.1111/j.1600-0501.2009.01964.x [ABSTRACT FROM AUTHOR]

Introduction: Sinus grafting is a technique oriented to facilitate implant placement in posterior atrophic maxillae. Several modifications of the original technique and a wide variety of materials have been proposed; most of them associated with implant survival rates. However, the quality of the bone obtained after the application of certain grafting materials has not been fully elucidated yet. The aims of this multicenter study were to analyse histomorphometrical samples obtained 6 months after sinus grafting using a composite graft consisting of anorganic bovine bone (ABB)+ autologous bone (AB), and to compare these samples with maxillary pristine bone biopsies. Material and methods: Ninety maxillary sinus augmentations were performed for delayed implant placement ( N=90) in 45 consecutive patients (test group). Bone cores were harvested 6 months after grafting for histomorphometric and ultrastructural study. Control pristine bone biopsies were taken from the posterior maxilla of 10 patients (control). Bone radiographic changes were assessed up to 24 months after implant loading. Results: The total mean values after analysis of test cores revealed a proportion of 46.08±16.6% of vital bone, 42.27±15.1% of non-mineralized connective tissue, and 37.02±25.1% of the remaining ABB particles. Significant bone remodeling activities were noticed in sinus grafting samples when compared with pristine bone. A statistically significant difference was observed in the number of osteoid lines between two groups, with higher values in the test one (15.1±11.48% vs. 2.5±2.2%, P=0.0005). Ultrastructural study showed that vital trabecular bone was in intimal contact with ABB particles. Radiographic analysis revealed that the higher the proportion of remaining ABB, the lower the total vertical resorption of the graft. Conclusion: Sinus grafting constitutes an excellent model for the study of de novo bone formation patterns and graft consolidation, when a combination of different bone substitutes is applied. The combination of ABB+AB yields highly satisfactory outcomes from both a clinical and a histologic perspective. To cite this article: Galindo-Moreno P, Moreno-Riestra I, Ávila G, Fernández-Barbero JE, Mesa F, Aguilar M, Wang H-L, O'Valle F. Histomorphometric comparison of maxillary pristine bone and composite bone graft biopsies obtained after sinus augmentation. Clin. Oral Impl. Res. 21, 2009; 122–128. [ABSTRACT FROM AUTHOR]

Aims/Background: Empirically, for implant placement associated with sinus floor augmentation, a minimum of five mm of residual crestal bone height has been recommended in order to achieve sufficient initial implant stability. It has been the aim of the study to test this assumption in an experimental animal trial. Material and methods: In eight mini pigs, three premolars and two molars were removed on one side of the maxilla. Three months later the animals were assigned to four groups of two animals each. A cavity was created at the base of the alveolar process so that the residual bone height was reduced to 2, 4, 6 and 8 mm, respectively. The coronal part of the alveolar crest remained unchanged. An inlay augmentation procedure was carried out using a particulated autogenous bone graft from the iliac crest, and six implants (Xive, diameter 3.8 mm, length 13 mm) were placed. Implant stability was assessed by resonance frequency analysis at the time of implant placement (T0), after 6 months of unloaded healing (T1) and after 6 months of functional loading (T2). Results: During follow-up, two implants were lost in sites with a residual alveolar bone height of 2 mm. At the time of implant placement, resonance frequencies were 6754.4±268, 6500.3±281.5, 6890.3±255.4 and 7877.9±233.7 Hz for residual bone heights of 2, 4, 6 and 8 mm, respectively. At stage-two surgery and after 6 months of functional loading, resonance frequencies were 6431.7±290.8, 6351.8±437.6, 6213.4±376.2 and 6826.8±458.9 Hz vs. 6171±437.4, 6047±572.4, 6156.7±272.6 and 6412.8±283.5 Hz. Statistical analysis revealed an association of residual alveolar height and implant stability at T0 and T1 only ( P<0.01), while bone height was not found to influence implant survival. Conclusion: The results of the present trial demonstrate an association of alveolar bone height and implant stability at the time of implant placement and stage-two surgery. Yet the assumption that 5 mm of residual crestal bone height is a relevant threshold for simultaneous implant placement and sinus floor augmentation is not supported from an experimental point of view. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the survival and success rates of implants installed utilizing the (transalveolar) osteotome technique, to compare peri-implant soft tissue parameters and marginal bone levels of osteotome-installed implants with implants placed using standard surgical procedures, and to evaluate patient-centered outcomes. Material and methods: During 2000 to 2005, 252 Straumann® dental implants were inserted in 181 patients. The surgical technique was a modification of the original osteotome technique presented by Summers. In addition to the clinical examination, the patients were asked to give their perception of the surgical procedure, utilizing a visual analogue scale. Results: The cumulative survival rate of the osteotome-installed implants after a mean follow-up time of 3.2 years, was 97.4% (95% confidence intervals: 94.4–98.8%). From the 252 implants inserted, three were lost before loading and another three were lost in the first and second year. According to residual bone height the survival was 91.3% for implant sites with ≤4 mm residual bone height, and 90% for sites with 4 mm and 5 mm, when compared with that of 100% in sites with bone height of above 5 mm. According to implant length the survival rates were 100% for 12 mm, 98.7% for 10 mm, 98.7% for 8 mm and only 47.6% for 6 mm implants. Soft tissue parameters (pocket probing depth, probing attachment level, bleeding on probing and marginal bone levels) did not yield any differences between the osteotome-installed and the conventionally placed implants. More than 90% of the patients were satisfied with the implant therapy and would undergo similar therapy again if necessary. The cost associated with implant therapy was considered to be justified. Conclusion: In conclusion, the osteotome technique was a reliable method for implant insertion in the posterior maxilla, especially at sites with 5 mm or more of preoperative residual bone height and a relatively flat sinus floor. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the pattern of tissue remodeling after maxillary sinus floor elevation using the transalveolar osteotome technique with or without utilizing grafting materials. Methods: During the period of 2000–2005, 252 Straumann® dental implants were inserted using the transalveolar sinus floor elevation technique in a group of 181 patients. For 88 or 35% of those implants, deproteinized bovine bone mineral with a particle size of 0.25–1 mm was used as the grafting material, but for the remaining 164 implants, no grafting material was utilized. Periapical radiographs were obtained with a paralleling technique and digitized. Two investigators, who were blinded to whether grafting material was used or not, subsequently evaluated the pattern of tissue remodeling. Results: The mean residual bone height was 7.5 mm (SD 2.2 mm), ranging from 2 to 12.7 mm. The mean residual bone height for implants placed with grafting material (6.4 mm) was significantly less compared with the implants installed without grafting material (8.1 mm). The implants penetrated on average 3.1 mm (SD 1.7 mm) into the sinus cavity. The measured mean radiographic bone gain using the transalveolar technique without grafting material was significantly less, 1.7 mm (SD 2 mm) compared with a mean bone gain of 4.1 mm (SD 2.4 mm), when grafting material was used. Furthermore, the probability of gaining 2 mm or more of new bone was 39.1% when no grafting material was used. The probability increased to 77.9% when the implants were installed with grafting material. Conclusion: When the transalveolar sinus floor elevation was performed without utilizing grafting material, only a moderate gain of new bone could be detected mesial and distal to the implants. On the other hand, when grafting material was used, a substantial gain of new bone was usually seen on the radiographs. [ABSTRACT FROM AUTHOR]

Aims/Background: For sinus floor augmentation and simultaneous implant placement, a minimum of 5 mm of residual bone height has been recommended empirically. This study was designed to test this assumption in an experimental animal trial. Material and methods: In eight mini pigs, three premolars and two molars were removed on one side of the maxilla. Three months later, the animals were assigned to four groups of two animals each. A cavity was created at the base of the alveolar process so that the residual bone height was reduced to 2, 4, 6 and 8 mm, respectively. Six implants were installed and an inlay augmentation procedure was carried out using a particulated iliac bone graft. Implants were loaded with fixed provisional restorations after a healing period of 6 months. The animals were sacrificed after 6 months of functional loading. Histologic specimens were prepared and histomorphometric analysis was performed [bone-to-implant contact (BIC) ratio, interthread bone area, peri-implant bone area, crestal bone resorption (CBR)]. Results: Two implants were lost during follow-up and fibrous encapsulation was detected in one additional implant. All failures occurred in one animal with a residual alveolar height of 2 mm. On the buccal aspect, BIC turned out to be significantly higher for 6 mm when compared with 2/4 mm (75.8 ± 26.1 vs. 58 ± 23.2/53.9 ± 22.8; P<0.05), while on the palatal aspect, BIC was significantly higher for 6/8 mm when compared with 2/4 mm (80 ± 17.8/78.9 ± 10.3 vs. 55.8 ± 26.5/55.6 ± 21.3; P<0.05). For an alveolar height of 8 mm, CBR tended to be significantly lower than for bone heights of 2/4 mm (3.8 ± 2.3 vs. 5.3 ± 2.6/5.8 ± 3.9; P<0.05). Correlation analysis revealed a significant association of BIC and interthread bone area as well as a negative association to CBR on the palatal aspect. Conclusion: The results of the present study show that the combination of maxillary inlay grafting and simultaneous implant placement does not hinder osseous integration even though the alveolar crest has been reduced to a residual height of 4 mm and below. However, according to histomorphometry, the highest predictability is gained in sites with residual bone heights of 6 and 8 mm. [ABSTRACT FROM AUTHOR]

Background and objectives: Sinus augmentation is a procedure used for augmenting insufficient bone height that is often observed in the maxillary posterior areas. Many different techniques as well as bone graft regimens have been suggested for performing this procedure. It was the goal of this study to compare, clinically and histologically, two different composite grafting regimens used for sinus augmentation. Material and methods: Five patients, needing a bilateral sinus augmentation to allow implant placement, were recruited for this study. Right sinuses were grafted with cortical bone (collected from overlying the sinus membrane) and bovine hydroxyapatite (HA), while the left side sinuses were grafted with overlying autologous bone plus a bioglass (BG) material. Bone core biopsies were taken at 6 months after sinus graft or at the time of implant insertion. A waiting period of 6 additional months was granted to allow healing, before prosthetic restoration and functional loading. The level of peri-implant bone was evaluated 12 months after loading. A comparative histomorphometric analysis was conducted and a statistical analysis was performed. Results: All implants in both groups were functional after a 12-month loading period. No bone loss was observed radiographically or clinically in both groups. Histologic analysis revealed that both composite grafts had a high biocompatibility. In the bovine HA-containing group, minimal xenogenic graft absorption was noted. In contrast, BG group samples presented a high absorption rate with some remaining particles imbedded in new normal bone. Conclusions: Sinus augmentation using a combination of autogenous bone plus either bovine HA or BG is a predictable technique. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this systematic review were to assess the survival rate of grafts and implants placed with sinus floor elevation. Material and Methods: An electronic search was conducted to identify studies on sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Results: The search provided 839 titles. Full-text analysis was performed for 175 articles resulting in 48 studies that met the inclusion criteria, reporting on 12,020 implants. Meta-analysis indicated an estimated annual failure rate of 3.48% [95% confidence interval (CI): 2.48%–4.88%] translating into a 3-year implant survival of 90.1% (95% CI: 86.4%–92.8%). However, when failure rates was analyzed on the subject level, the estimated annual failure was 6.04% (95% CI: 3.87%–9.43%) translating into 16.6% (95% CI: 10.9%–24.6%) of the subjects experiencing implant loss over 3 years. Conclusion: The insertion of dental implants in combination with maxillary sinus floor elevation is a predictable treatment method showing high implant survival rates and low incidences of surgical complications. The best results (98.3% implant survival after 3 years) were obtained using rough surface implants with membrane coverage of the lateral window. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this systematic review were to assess the survival rate of implants placed in sites with transalveolar sinus floor elevation. Material and Methods: An electronic search was conducted to identify prospective and retrospective cohort studies on transalveolar sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates/ year proportions. Results: The search provided 849 titles. Full-text analysis was performed for 176 articles, resulting in 19 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated annual failure rate of 2.48% (95% confidence interval (95% CI): 1.37–4.49%) translating to an estimated survival rate of 92.8% (95% CI): 87.4–96.0%) for implants placed in transalveolarly augmented sinuses, after 3 years in function. Furthermore, subject-based analysis revealed an estimated annual failure of 3.71% (95% CI: 1.21–11.38%), translating to 10.5% (95% CI: 3.6–28.9%) of the subjects experiencing implant loss over 3 years. Conclusion: Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable to those in non-augmented sites. This technique is predictable with a low incidence of complications during and post-operatively. [ABSTRACT FROM AUTHOR]