Abstract：
OBJECTIVE: To establish consensus-driven guidelines that could support the clinical decision-making process for implant-supported rehabilitation of the posterior atrophic maxilla and ultimately improve long-term treatment outcomes and patient satisfaction.
METHODS: A total of 33 participants were enrolled (18 active members of the Italian Academy of Osseointegration and 15 international experts). Based on the available evidence, the development group discussed and proposed an initial list of 20 statements, which were later evalu-ated by all participants. After the forms were completed, the responses were sent for blinded ana-lysis. In most cases, when a consensus was not reached, the statements were rephrased and sent to the participants for another round of evaluation. Three rounds were planned.
RESULTS: After the first round of voting, participants came close to reaching a consensus on six statements, but no consensus was achieved for the other fourteen. Following this, nineteen statements were rephrased and sent to participants again for the second round of voting, after which a consensus was reached for six statements and almost reached for three statements, but no consensus was achieved for the other ten. All 13 statements upon which no consensus was reached were rephrased and included in the third round. After this round, a consensus was achieved for an additional nine statements and almost achieved for three statements, but no consensus was reached for the remaining statement.
CONCLUSIONS: This Delphi consensus highlights the importance of accurate preoperative planning, taking into consideration the maxillomandibular relationship to meet the functional and aesthetic requirements of the final restoration. Emphasis is placed on the role played by the sinus bony walls and floor in providing essential elements for bone formation, and on evaluation of bucco-palatal sinus width for choosing between lateral and transcrestal sinus floor elevation. Tilted and trans-sinus implants are considered viable options, whereas caution is advised when placing pterygoid implants. Zygomatic implants are seen as a potential option in specific cases, such as for completely edentulous elderly or oncological patients, for whom conventional alternatives are unsuitable.
METHODS: A total of 33 participants were enrolled (18 active members of the Italian Academy of Osseointegration and 15 international experts). Based on the available evidence, the development group discussed and proposed an initial list of 20 statements, which were later evalu-ated by all participants. After the forms were completed, the responses were sent for blinded ana-lysis. In most cases, when a consensus was not reached, the statements were rephrased and sent to the participants for another round of evaluation. Three rounds were planned.
RESULTS: After the first round of voting, participants came close to reaching a consensus on six statements, but no consensus was achieved for the other fourteen. Following this, nineteen statements were rephrased and sent to participants again for the second round of voting, after which a consensus was reached for six statements and almost reached for three statements, but no consensus was achieved for the other ten. All 13 statements upon which no consensus was reached were rephrased and included in the third round. After this round, a consensus was achieved for an additional nine statements and almost achieved for three statements, but no consensus was reached for the remaining statement.
CONCLUSIONS: This Delphi consensus highlights the importance of accurate preoperative planning, taking into consideration the maxillomandibular relationship to meet the functional and aesthetic requirements of the final restoration. Emphasis is placed on the role played by the sinus bony walls and floor in providing essential elements for bone formation, and on evaluation of bucco-palatal sinus width for choosing between lateral and transcrestal sinus floor elevation. Tilted and trans-sinus implants are considered viable options, whereas caution is advised when placing pterygoid implants. Zygomatic implants are seen as a potential option in specific cases, such as for completely edentulous elderly or oncological patients, for whom conventional alternatives are unsuitable.
摘要：
目的：建立共识驱动的指南，以支持种植体支持的后萎缩上颌骨康复的临床决策过程，并最终改善长期治疗结果和患者满意度。
方法：共招募了33名参与者（18名意大利骨整合学会成员和15名国际专家）。根据现有证据,开发小组讨论并提出了一份20份声明的初步清单，后来被所有参与者评估。表格完成后，应答被发送用于盲法分析。在大多数情况下,当没有达成共识时，声明被重新措辞，并发送给参与者进行另一轮评估。计划了三轮。
结果：第一轮投票后，与会者接近就六项声明达成共识，但是其他十四个没有达成共识。在此之后,十九份声明被重新措辞，并再次发送给与会者进行第二轮投票，此后，六项声明达成共识，三项声明几乎达成共识，但是其他十个没有达成共识。没有达成共识的所有13项声明都被重新措辞，并列入第三轮。在这一轮之后,另外九次发言达成共识，三次发言几乎达成共识，但是对于其余的声明没有达成共识。
结论：本德尔菲共识强调了准确术前计划的重要性，考虑到上颌下颌关系，以满足最终修复的功能和美学要求。重点放在鼻窦骨壁和骨底在提供骨形成基本要素方面所起的作用。并评估颊-腭窦宽度，以在外侧和经窦底抬高之间进行选择。倾斜和经窦植入物被认为是可行的选择，而放置翼状体植入物时建议谨慎。在特定情况下，颌骨植入物被视为一种潜在的选择，例如对于完全无牙的老年人或肿瘤患者，传统的替代品不适合他们。
方法：共招募了33名参与者（18名意大利骨整合学会成员和15名国际专家）。根据现有证据,开发小组讨论并提出了一份20份声明的初步清单，后来被所有参与者评估。表格完成后，应答被发送用于盲法分析。在大多数情况下,当没有达成共识时，声明被重新措辞，并发送给参与者进行另一轮评估。计划了三轮。
结果：第一轮投票后，与会者接近就六项声明达成共识，但是其他十四个没有达成共识。在此之后,十九份声明被重新措辞，并再次发送给与会者进行第二轮投票，此后，六项声明达成共识，三项声明几乎达成共识，但是其他十个没有达成共识。没有达成共识的所有13项声明都被重新措辞，并列入第三轮。在这一轮之后,另外九次发言达成共识，三次发言几乎达成共识，但是对于其余的声明没有达成共识。
结论：本德尔菲共识强调了准确术前计划的重要性，考虑到上颌下颌关系，以满足最终修复的功能和美学要求。重点放在鼻窦骨壁和骨底在提供骨形成基本要素方面所起的作用。并评估颊-腭窦宽度，以在外侧和经窦底抬高之间进行选择。倾斜和经窦植入物被认为是可行的选择，而放置翼状体植入物时建议谨慎。在特定情况下，颌骨植入物被视为一种潜在的选择，例如对于完全无牙的老年人或肿瘤患者，传统的替代品不适合他们。
