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- 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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| 7. |
- Pistilli, R., et al.
(författare)
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Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: Preliminary data from a pilot randomised controlled trial
- 2014
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 7:2, s. 153-171
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare the effectiveness of onlay bone blocks of equine origin (test or XB group) with autogenous bone blocks (control or AB group) harvested from the ramus or the iliac crest for the rehabilitation of partially or fully edentulous atrophic jaws with implant supported prostheses. Materials and methods: Forty patients with partially or fully edentulous atrophic jaws having less than 5 mm of residual crestal bone height and/or less than 3 mm of bone thickness, as measured on computerised tomography (CT) scans, were randomised into two groups according to a parallel group design, either to be augmented with autogenous onlay bone blocks (20 patients; AB group) from the mandibular ramus or the iliac crest, or with onlays blocks of spongious bone of equine origin (20 patients; XB group). Two centres treated 20 patients each. Six XB blocks were modelled on lithographic models of the jaws before grafting. The blocks were fixed with screws and osteosynthesis plates and were covered with resorbable barriers made of equine cortical bone and fixed with tacks. The autogenous bone grafts were left to heal for 4 months and the xenografts for 7 months before placing implants, which were submerged. After 4 months, either bar-retained overdentures or provisional reinforced acrylic prostheses were delivered. Provisional prostheses were replaced, after 4 months, by definitive fixed prostheses. Outcome measures were: prosthesis and implant failures; complications; patient satisfaction; pain recorded 3 and 10 days post-augmentation; number of days of hospitalisation, total and partial infirmity days. All patients were followed for 4 months after loading. Results: All patients could be rehabilitated with implant-supported prostheses and none dropped out. Twenty-eight patients were augmented in the maxilla (15 with AB and 13 with XB) and 12 in the mandible (5 with AB and 7 with XB). No AB graft failed totally versus 10 XB grafts (difference = 0.5; 95% CI 0.23 to 0.68; P = 0.0004). In particular, all 7 XB mandibular grafts and 5 out of 6 XB blocks (3 in mandibles and 2 in maxillas), which were previously modelled on lithographic models of the jaws failed. One implant failed in one AB patient versus 11 implants in 4 XB patients (P = 0.3416). All but 1 prostheses were loaded in time in the AB patients, versus 4 prostheses which were loaded with delays in XB patients because of graft and implant failures (P = 0.3416). Four complications occurred in 4 AB patients versus 15 complications in 12 XB patients (difference = 0.4; 95% CI 0.09 to 0.63; P = 0.0225). Fourteen AB patients reported moderate pain 3 days postoperatively versus 6 XB patients (P = 0.0562); at 10 days, 10 AB patients reported moderate pain versus 1 XB patient (difference = -0.45; 95% CI -0.65 to -0.17; P = 0.0033). The 14 patients harvested from the iliac crest were hospitalised for an average of 3.1 nights, whereas 7 patients treated with XB were hospitalised on average for 1.4 nights (P < 0.0001). The number of total and partial infirmity days was 126 for the AB group and 43 for the XB group, and 220 for the AB group and 93 for the XB group, respectively (mean day difference = -4.15; 95% CI -7.35 to -0.95; P = 0.0134 and mean day difference = -5.7; 95% CI -10.01 to -1.39; P = 0.0116, respectively). Seventeen AB patients versus 19 XB patients were fully satisfied with function of their prostheses (P = 0.6050), 18 AB patients versus 12 XB patients were fully satisfied with aesthetics of their prostheses (P = 0.0648), and 5 and 3 patients, respectively would not undergo the same procedure again (P = 0.6948). There were no differences between the outcomes of the two centres with exception of prosthesis failures and complications in the maxilla. Conclusions: Autogenous onlay bone blocks are superior to equine onlay bone blocks, especially in mandibles, where all equine blocks failed, therefore we strongly discourage the use of onlay bone blocks of equine origin in mandibles.
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| 8. |
- 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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