Osteotome sinus floor elevation technique without grafting material: 3-year results of a prospective pilot study

• Published in: Clinical oral implants research 2009-07, Vol.20 (7), p.701-707
• Main Authors: Nedir, Rabah, Bischof, Mark, Vazquez, Lydia, Nurdin, Nathalie, Szmukler-Moncler, Serge, Bernard, Jean-Pierre
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alveolar Bone Loss - diagnostic imaging; Alveolar Bone Loss - surgery; Alveolar Process - diagnostic imaging; Alveolar Process - pathology; Alveolar Ridge Augmentation - methods; crestal bone loss; Dental Abutments; Dental Implants; Dental Prosthesis Design; Dentistry; Female; Follow-Up Studies; grafting material; Humans; Image Processing, Computer-Assisted; Male; Maxilla - surgery; Maxillary Sinus - surgery; Middle Aged; Osseointegration - physiology; Osteogenesis - physiology; Osteotomy - instrumentation; Osteotomy - methods; Pilot Projects; posterior maxilla; Prospective Studies; Radiography, Bitewing; sinus lift; sinus osteotome; Survival Analysis; Treatment Outcome; Wound Healing - physiology
• ISSN: 0905-7161; 1600-0501
• DOI: 10.1111/j.1600-0501.2008.01696.x

Objective: In a prospective pilot study, short≤10 mm ITI‐SLA implants were placed in the resorbed posterior maxilla by means of an osteotome sinus floor elevation (OSFE) procedure without grafting material. This paper presents 3‐year data assessing bone‐level changes around implants. Material and methods: Twenty‐five implants were placed in 17 patients to rehabilitate 16 molar and nine premolar sites. The mean residual bone height (RBH) was 5.4 ± 2.3 mm. A healing period of 3–4 months was allowed before abutment tightening. Most implants (21/25) were 10 mm long, and the others were 8 and 6 mm long. At the 3‐year control, endo‐sinus bone gain, implant length protruding into the sinus and crestal bone loss (CBL) were measured on periapical radiographs. Results: All implants fulfilled the survival criteria. Despite the absence of grafting material, implants were embedded into newly formed bone tissue. All implants gained endo‐sinus bone; the mean gained bone was 3.1 ± 1.5 mm. The residual protrusion length decreased from 4.9 ± 2.1 to 1.8 ± 2.1 mm. CBL was 0.9 ± 0.8 mm. Conclusions: This study confirms that the OSFE procedure without grafting material is sufficient to create bone beyond the natural limit of the sinus. On the mid‐term of 3 years, the technique was found to be predictable in the posterior maxilla when the RBH is limited. Implants gained endo‐sinus bone despite the lack of grafting material. Bone gain was still improving over the first‐year control. No shrinkage of the augmented area was observed.