Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study
Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study
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DOI：
10.1111/clr.12893
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发表时间：
2017-07-01
影响因子：
4.3
通讯作者：
Bischof, Mark
中科院分区：
文献类型：
--
作者：
Nedir, Rahah;Nurdin, Nathalie;Bischof, Mark
目的：(I)评价8 mm种植体在极度萎缩的上颌骨中应用骨刀窦底提升(OSFE)的临床效果；(Ii)比较种植体植入前后周围的骨水平。材料与方法将TE(R)SLActive(R)种植体(Institut Strutrann AG，瑞士巴塞尔)植入残骨高度为4 mm的部位。在手术前，鼻窦被随机分为两组，一组接受无机牛骨(对照)，另一组不接受移植(测试)。愈合10周后，种植体单冠功能充填。结果12例患者共植入种植体37枚(试验组17枚，对照组20枚)，根尖周血径为2.40.9 mm。发生了两次早期故障和一次后期故障。成功率91.9%(试验组94.1%，对照组90.0%)。所有种植体均获得窦内骨(试验组为3.8±-1.0 mm，对照组为4.8±-1.2 mm，P=0.004)。平均峰值骨丢失为0.527.6±-1.1 mm，组间差异无统计学意义(P=0.0 5)。1~5年间平均骨量和CBL值差异无统计学意义(分别为P=0.249和P=0.293)。结论上颌后牙种植种植体能有效修复后牙萎缩。种植体周围形成的新骨在1年后稳定，5年后稳定，无论有无移植。平均增大3.8 mm不需要植骨，但植骨获得了更多的骨量。
ObjectivesOver 5years, (i) to evaluate the clinical efficiency of 8-mm implants placed with osteotome sinus floor elevation (OSFE) in extremely atrophic maxillae and (ii) to compare bone levels around implants placed with and without grafting.Material and methodsTE((R)) SLActive((R)) implants (Institut Straumann AG, Basel, Switzerland) were placed in sites with a residual bone height (RBH) of 4mm. Before surgery, sinuses were randomized to receive anorganic bovine bone (control) or no graft (test). After 10weeks of healing, implants were functionally loaded with single crowns. Bone levels were measured from standardized peri-apical radiographs.ResultsThirty-seven (17 test, 20 control) implants were placed in 12 patients (RBH: 2.40.9mm). Two early and one late failures occurred. The success rate was 91.9% (94.1% test, 90.0% control). All implants gained endo-sinus bone (3.8 +/- 1.0mm test, 4.8 +/- 1.2mm control; P=0.004). Mean crestal bone loss (CBL) was 0.6 +/- 1.1mm, without a significant difference between the groups (P=0.527). Mean bone gain and CBL did not change significantly between 1 and 5years (P=0.249 and P=0.293, respectively).ConclusionsAtrophic posterior maxillae can be predictably rehabilitated using OSFE with a simultaneous implant placement. The new bone formed around implants after 1year was stable after 5years, irrespective of the presence or the absence of graft. Grafting was unnecessary to achieve an average bone augmentation of 3.8mm, but more bone was gained with grafting.