| 1. |
- Esposito, Marco, 1965, et al.
(författare)
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Cosci versus Summers technique for crestal sinus lift: 3-year results from a randomised controlled trial
- 2014
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 7:2, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effectiveness of two different techniques to lift the maxillary sinus via a crestal approach: the Summers versus the Cosci technique. Materials and methods: Fifteen partially edentulous patients missing bilaterally maxillary molars and/or premolars, having 4 to 7 mm of residual crestal height and at least 5 mm thickness below the maxillary sinuses measured on CT scans, were randomised to have implants placed in sinuses crestally lifted according to the Cosci or the Summers techniques, with bone substitutes according to a split-mouth design. Implants were left to heal submerged for 6 months. Implants were loaded with acrylic provisional crowns/prostheses. Screw-retained definitive metal-ceramic prostheses were delivered 4 months after provisional loading. Outcome measures were: prosthesis and implant failures; any complications; operation time; operator preference; patient preference and peri-implant marginal bone level changes assessed by a blinded outcome assessor. All patients were followed to 3 years after implant loading. Results: Nineteen study implants were placed according to each technique. Three years after loading, 3 patients dropped out and no implant failed. No discomfort/complications occurred at sites treated with the Cosci technique, whereas 12 patients reported discomfort during the augmentation procedure at the side treated with the Summers technique; this was statistically significant (P = 0.0005). In one of these patients, a perforation of the sinus membrane occurred. Postoperatively, headache was reported by 9 patients and swelling occurred in 3 of these patients at the Summers treated sides. Statistically significant less time (9.7 mins, SD = 4.0, P < 0.001, 95% CI -11.9 to -7.5) was required to place implants according to the Cosci technique (33 versus 24 mins on average). The 2 operators and 14 out of 15 patients preferred the Cosci technique 1 month after surgery (P = 0.001), and 1 year after surgery (13 out of 15 patients, P = 0.007). The ceramic layer of one prosthesis of the Summers' group and one abutment screw of the Cosci's group loosened between 1 to 3 years post-loading. After 3 years, implants inserted according to the Cosci technique lost 1.39 mm of peri-implant bone versus 1.54 mm for the implants placed with the Summers technique. There were no statistically significant differences for marginal bone level changes between the two groups (difference 0.15 mm, 95% CI -0.11 to 0.41, P = 0.24). Conclusions: Both crestal sinus lift techniques produced successful results over a 3-year follow-up period, but the Cosci technique required less surgical time, determined less intra- and postoperative morbidity and was preferred by patients.
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| 2. |
- Felice, P., et al.
(författare)
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1-stage versus 2-stage lateral maxillary sinus lift procedures: 4-month post-loading results of a multicenter randomised controlled trial
- 2013
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 6:2, s. 153-165
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the efficacy of 1-stage versus 2-stage lateral maxillary sinus lift procedures. Materials and methods: Sixty partially edentulous patients requiring 1 to 3 implants and having 1 to 3 mm of residual bone height and at least 5 mm of bone width below the maxillary sinus, as measured on CT scans, were randomised into two equal groups to receive either a 1-stage lateral window sinus lift with simultaneous implant placement or a 2-stage procedure with implant placement delayed by 4 months using a bone substitute in 3 different centres. Implants were submerged for 4 months and loaded with reinforced provisional prostheses, which were replaced, after 4 months, by definitive prostheses. Outcome measures were augmentation procedure failures, prosthesis failures, implant failures, complications and marginal pen-implant bone loss assessed by a blinded outcome assessor. Patients were followed up to 4 months after loading. Only data of implants placed in 1 to 3 mm of bone height were reported. Results: Two patients dropped out from the 1-stage group and none from the 2-stage group. No sinus lift procedure failed in the 1-stage group but 1 failed in the 2-stage group, the difference was not statistically significant (P = 1.00). Two prostheses failed or could not be placed in the planned time in the 1-stage group and 1 in the 2-stage group, the difference was not statistically significant (P = 0.51). Three implants failed in 3 patients of the 1-stage group versus 1 implant in the 2-stage group, the difference was not statistically significant (P = 0.28). Two complications occurred in the 1-stage group and 1 in the 2-stage group, the difference was not statistically significant (P = 0.61). There were no statistically significant differences in bone loss between groups at loading (0.05 mm). Sites treated in 1 stage lost an average of 0.56mm (SD: 0.36; 95% Cl: -0.70 to -0.42; P < 0.001) of pen-implant bone and 2-stage sites approximately 0.61 mm (SD: 0.34; 95% Cl: -0.74 to -0.48; P < 0.001). Conclusions: No statistically significant differences were observed between implants placed according to 1- or 2-stage sinus lift procedures. However, this study may suggest that in patients having a residual bone height between 1 and 3 mm below the maxillary sinus there might be a slightly higher risk for implant failures when performing a 1-stage lateral sinus lift procedure.
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| 3. |
- Felice, P., et al.
(författare)
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1-stage versus 2-stage lateral sinus lift procedures: 1-year post-loading results of a multicentre randomised controlled trial
- 2014
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 7:1, s. 65-75
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the efficacy of 1-stage versus 2-stage lateral maxillary sinus lift procedures. Materials and methods: Sixty partially edentulous patients requiring 1 to 3 implants and having 1 to 3 mm of residual bone height and at least 5 mm bone width below the maxillary sinus, as measured on CT scans were selected. They were randomised according to a parallel group study design into two equal arms to receive either a 1-stage lateral window sinus lift with simultaneous implant placement or a 2-stage procedure with implant placement delayed by 4 months, using a bone substitute in three different centres. Implants were submerged for 4 months, loaded with reinforced provisional prostheses, which were replaced, after 4 months, by definitive prostheses. Outcome measures, assessed by masked assessors, were: augmentation procedure failures; prosthesis failures and implant failures; complications; and marginal pen-implant bone level changes. Patients were followed up to 1 year after loading. Only data of implants placed in 1 to 3 mm of bone height were reported. Results: Two patients dropped out from the 1-stage group and none from the 2-stage group. No sinus lift procedure failed in the 1-stage group but one failed in the 2-stage group, the difference being not statistically significant (P = 1.00). Two prostheses failed or could not be placed in the planned time in the 1-stage group and one in the 2-stage group, the difference being not statistically significant (P = 0.51). Three implants failed in three patients of the 1-stage group, versus one implant in the 2-stage group, the difference being not statistically significant (P = 0.28). Two complications occurred in the 1-stage group and one in the 2-stage group, the difference being not statistically significant (P = 0.61). One year after loading, 1-stage treated patients lost an average of -1.01 mm (SD: 0.56) of pen-implant bone and 2-stage sites about -0.93 mm (SD: 0.40). There were no statistically significant differences in bone level change between groups 1 year after loading (-0.08 mm 95%CI: -0.33 to 0.18 P = 0.56). Conclusion: No statistically significant differences were observed between implants placed according to 1- or 2-stage sinus lift procedures. However this study may suggest that in patients having residual bone height between 1 to 3 mm below the maxillary sinus, there might be a slightly higher risk for implant failures when performing a 1-stage lateral sinus lift procedure.
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| 4. |
- Pistilli, R., et al.
(författare)
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Posterior atrophic jaws rehabilitated with prostheses supported by 5 x 5 mm implants with a novel nanostructured calcium-incorporated titanium surface or by longer implants in augmented bone. One-year results from a randomised controlled trial
- 2013
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 6:4, s. 343-357
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate whether 5 x 5 mm dental implants with a novel nanostructured calcium-incorporated titanium surface could be an alternative to implants at least 10 mm long placed in bone augmented with bone substitutes in posterior atrophic jaws. Materials and methods: A total of 40 patients with atrophic posterior (premolar and molar areas) mandibles having 5 to 7 mm of bone height above the mandibular canal and 40 patients with atrophic maxillae having 4 to 6 mm below the maxillary sinus, were randomised according to a parallel group design to receive one to three 5 mm implants or one to three at least 10 mm-long implants in augmented bone at two centres. All implants had a diameter of 5 mm. Mandibles were vertically augmented with interpositional bovine bone blocks and resorbable barriers. Implants were placed after 4 months. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers and implants were placed simultaneously. All implants were submerged and loaded after 4 months with provisional prostheses. Four months later, definitive screw-retained or provisionally cemented metal-ceramic or zirconia prostheses were delivered. Patients were followed up to 1 year post-loading and the outcome measures were prosthesis and implant failures, any complications and pen-implant marginal bone level changes. Results: One maxillary grafted patient dropped out before the 1-year evaluation. In mandibles, 1 grafted patient did not want to go ahead with the treatment because of multiple complications and graft failure, and another grafted patient did not receive his prostheses due the loss of 2 implants. In maxillae, one 5 x 5 mm implant failed with its provisional crown 3 months post-loading. There were no statistically significant differences in prostheses and implant failures. Significantly more complications occurred at both mandibular and maxillary grafted sites: 17 augmented patients were affected by complications versus 8 patients treated with short implants in the mandible (P = 0.0079; difference in proportion = -0.45; 95% Cl -0.67 to -0.15), and 5 sinus-lift patients versus none treated with maxillary short implants (P = 0.047; difference in proportion = -0.25; 95% Cl -0.44 to -0.06). Patients with mandibular short implants lost on average 0.94 mm of pen-implant bone at 1 year and patients with 10 mm or longer mandibular implants lost 1.03 mm. Patients with maxillary short implants lost on average 0.87 mm of pen-implant bone at 1 year and patients with 10 mm or longer maxillary implants lost 1.15 mm. There were no statistically significant differences in bone level changes up to 1 year between short and longer implants in maxillae (mean difference -0.28 mm, 95% Cl -0.56 to 0.01, P = 0.051) and in mandibles (mean difference -0.09 mm, 95% Cl -0.26 to 0.08, P = 0.295). Conclusions: One year after loading, 5 x 5 mm implants achieved similar results compared to longer implants placed in augmented bone. Short implants might be a preferable choice to bone augmentation especially in posterior mandibles since the treatment is faster, cheaper and associated with less morbidity, however 5 to 10 years of post-loading data are necessary before making reliable recommendations.
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