Dataset Information

Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: a preliminary study.

ABSTRACT:

Background

Osteotome sinus floor elevation (OSFE) is used to increase the bone volume at the site of the maxillary sinus through the transalveolar approach. However, there is uncertainty regarding the necessity of the use of grafting material in order to maintain the space for new bone formation.

Objective

This study aimed to evaluate new bone formation 6 months after osteotome sinus floor elevation without grafting and to evaluate the correlations between residual bone height (RBH), implant protrusion length (IPL), and endo-sinus bone gain (ESBG).

Material and methods

Thirty-one implants (27 patients) from area 14-17 and 24-27 were included in the study. All implants had a history of OSFE without grafting, with cone beam computed tomography (CBCT) taken prior to the surgery. The clinical examination and radiographic examination using CBCT were performed again 6 months after implantation. The RBH, new bone level, ESBG, and IPL were measured. Paired sample t test and Pearson correlation were used to analyze the data.

Results

The average RBH before surgery was 7.14 ± 1.07?mm and 6?months after surgery was 8.95 ± 1.17?mm. There was a significant increase in new bone formation in the 6 months following surgery (p < 0.05). The average ESBG and IPL were 1.8 ± 0.79?mm and 2.02 ± 0.73?mm, respectively. There was a significant positive correlation between the IPL and ESBG (p < 0.05) while there was a negative correlation between RBH and ESBG. This study also demonstrates a decrease in the percentage of bone formation in relation to IPL as the IPL increases. The survival rate of the implant was 100%.

Conclusion

Significant new bone formation can be detected around the implant site 6 months after implantation using OSFE technique without grafting. There is a negative correlation between the RBH and ESBG. While IPL is correlated to ESBG and appears to be the influencing factors of bone formation changes in the maxillary sinus. The preliminary radiographic results suggest that OSFE technique without grafting in combination with optimal IPL can provide sufficient bone height for implant support with a 100% implant survival rate.

SUBMITTER: Suk-Arj P

PROVIDER: S-EPMC6669224 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: a preliminary study.

Suk-Arj Panapohn P Wongchuensoontorn Chanchai C Taebunpakul Patrayu P

International journal of implant dentistry 20190801 1

<h4>Background</h4>Osteotome sinus floor elevation (OSFE) is used to increase the bone volume at the site of the maxillary sinus through the transalveolar approach. However, there is uncertainty regarding the necessity of the use of grafting material in order to maintain the space for new bone formation.<h4>Objective</h4>This study aimed to evaluate new bone formation 6 months after osteotome sinus floor elevation without grafting and to evaluate the correlations between residual bone height (RB ...[more]

PMID: 31367919

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Project description:BackgroundImplant placement in the posterior maxilla is often complicated by the insufficient bone volume. While transalveolar sinus floor elevation (TSFE) has been proven as a predictable surgical procedure to increase the bone height in the posterior maxilla, questions in regard to the necessity of the bone grafting during the sinus lift and the question of whether TSFE could be performed when the residual bone height is below 5 mm are still debated. Furthermore, high-quality evidence comparing the clinical outcome of transalveolar sinus floor elevation with osteotome and modified sinus floor elevation with crestal non-cutting drills is limited.Methods/designOne hundred twenty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology First Clinical Division (Beijing, China). All patients are assigned to one of four groups according to a table of random numbers. Participants will receive (1) TSFE using osteotomes with bone grafting, (2) TSFE using osteotomes without bone grafting, (3) modified TSFE with bone grafting, or (4) modified TSFE without bone grafting. In a one-year follow-up period, implant survival rates, complications, implant stability, bone remodeling around the implant, and patient-reported outcome (visual analog scale for intraoperative discomfort and postoperative pain) will be observed and documented. The implant stability will be gauged by the resonance frequency analysis six times (at baseline and weeks 6, 8, 12, 16, and 26), and the bone remodeling will be observed and compared via radiographic examinations.DiscussionThe result of the trial will potentially contribute to better decision making in atrophic posterior maxilla when implant placement is needed. Therefore, if the outcome is deemed favorable, the use of the modified TSFE would achieve an outcome equivalent to that of the traditional TSFE while introducing less trauma and postoperative discomforts. Separately, whether the bone graft procedure is necessary for the TSFE will also be discussed.Trial registrationThe study has been registered in ClinicalTrials.gov under the identifier number NCT03445039 . Registered on 26 February 2018.

Project description:Nowadays, short dental implants are being increasingly applied in extremely resorbed posterior regions. The recent studies have indicated that short implants present a similar success rate to conventional implants. It is assumed that short implants can avoid additional surgical morbidity and are less technically demanding. However, high-quality evidence (? Ib: evidence from at least one randomized controlled trial) on comparing the clinical outcome of short implants and longer implants combined with osteotome sinus floor elevation (OSFE) technique is limited.The proposed study is designed as a prospective single-center, three-arm parallel group, randomized controlled trial. We plan to enroll 150 patients in need of dental implant treatment in the posterior maxilla. The inclusion criteria include: age ? 18 years, partial edentulism in the posterior maxilla for at least 3 months from tooth loss, residual bone height ranging from 6 to 8 mm, sufficient bone width (? 6 mm) in the edentulous region. The patients will be divided into three groups according to a table of random numbers: group 1: short implants (6 mm) alone; group 2: short implants (8 mm) combined with osteotome sinus floor elevation (OSFE); group 3: standard implants (10 mm) combined with OSFE. The assignment will be concealed from the clinical operators until the beginning of implant surgery. The outcome examiners and patients will be kept blinded to the assignment. Implant survival rates, implant success rates, complications, resonance frequency analysis (RFA) measurements, marginal bone level, treatment time and patient-reported outcome (visual analogue scale for intraoperative discomfort and postoperative pain) will be recorded. Clinical re-evaluations will be performed at 12, 24, 36 and 60 months after crown placement.The results of the trial will support better decision-making for dental implant treatment in atrophic maxillary ridges. If favorable, the use of short implants may avoid adjunct procedures used for implant insertion, thus reducing operative time, complexity and postoperative discomfort.Clinicaltrials.gov identifier: NCT02350075 (registered on 17 February 2015).

Dataset Information

Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: a preliminary study.

Background

Objective

Material and methods

Results

Conclusion

Publications

Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: a preliminary study.

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