Abstract:
The aim of this retrospective case series was to evaluate the clinical and radiographic outcomes of the patients that underwent implant surgery with a modification of the sinus lift summers protocol. Forty healthy patients in need for oral rehabilitation with dental implants were included in this study. Inclusion criterion was the need for extraction of one compromised tooth due to persistent abscess/ periodontitis/cyst in the atrophic posterior maxilla region. The treatment consisted of two stage surgery for all patients. In the first stage, after tooth extraction, the sockets were preserved with allogenic bone graft and equine collagen membrane. After 4-5 months, 40 implants with a sandblasted surface, were inserted with osseodensification technique and a modification of the Summers sinus lift protocol for fracturing the sinus floor. The implant survival rate was the primary outcome. Intra- and postoperative complications were additional criteria for success. The mean follow-up from implant surgery was 28.0±7.3 (standard deviation) months (range 17.8-43.4 months). One implant was lost before the delivery of the prosthesis. The overall implant survival rate was 97.5%. The overall mean peri-implant marginal bone level change after 6 and 12 months of function was, respectively, 0.26±0.24 mm (95% CI: 0.19, 0.34 mm) and 0.71±0.36 mm (95% CI: 0.60, 0.82 mm). Marginal bone loss was statistically significant at both time frames respect to implant placement, and also the difference between 6 and 12 months was significant (p<0.001 in both cases). No biological nor mechanical complications were recorded throughout the observation period. As a conclusion, the technique presented in this cohort study can be an effective and safe alternative to standard maxillary sinus floor augmentation procedures and immediate implant insertion protocol, especially in cases of periodontitis and infected sites, which can represent a high risk for implant failure in patients with atrophic posterior maxilla.
摘要:
此回顾性病例系列的目的是通过修改鼻窦提升夏季方案来评估接受植入物手术的患者的临床和影像学结果。本研究包括40名需要使用牙种植体进行口腔修复的健康患者。纳入标准是由于萎缩性上颌骨后部的持续性脓肿/牙周炎/囊肿,需要拔除一颗受损的牙齿。治疗包括对所有患者进行两个阶段的手术。在第一阶段,拔牙后,用同种异体骨移植和马胶原膜保存。4-5个月后,40个表面喷砂的植入物,插入骨致密化技术和改良的Summers鼻窦提升方案以压裂鼻窦底。植入物存活率是主要结果。术中和术后并发症是成功的额外标准。植入手术的平均随访时间为28.0±7.3(标准偏差)个月(范围为17.8-43.4个月)。在递送假体之前丢失了一个植入物。植入物的总存活率为97.5%。术后6个月和12个月的总体平均种植体周围边缘骨水平变化为,分别,0.26±0.24mm(95%CI:0.19,0.34mm)和0.71±0.36mm(95%CI:0.60,0.82mm)。在植入物放置的两个时间范围内,边缘骨丢失均具有统计学意义,6个月和12个月之间的差异也是显着的(p<0.001)。在整个观察期间均未记录到生物或机械并发症。作为结论,这项队列研究中提出的技术可以是标准上颌窦底增强手术和立即植入物插入方案的有效和安全的替代方案,特别是在牙周炎和感染部位的情况下,这可能代表了萎缩性后上颌骨患者植入物失败的高风险。