Sinus lifting procedure. I : one stage surgery with bone transplant and implants

Aim of the study

To evaluate and analyse the results of sinus bone grafts with simultaneous placement of implants.

Materials and methods

Twenty-six patients with unilateral or bilateral loss of teeth in the posterior maxilla underwent sinus lift grafts with iliac bone and, at the same surgical visit, had 126 implants inserted. The abutments were connected 6 months later. Provisional bridges were subsequently placed for 6 to 12 months, prior to the definitive bridges. Clinical and radiographic follow up was carried out annually for 5 years.

Results

After 5 years, the survival rate for implants placed in bone grafts was approximately 60 %. The results were better in the partially edentulous, compared with the totally edentulous cases. Over 20 % of the bone transplants were resorbed at 1 year and close to 10 % more by 3 years. After 3 years, a degree of stability was observed. Sinusitis became apparent or was aggravated in several patients.

Conclusion

The placement of implants as well as simultaneous sinus lift grafts with iliac bone gives deceptive results. The two stage technique must be preferable in cases where bone grafts are necessary to enable implants to be placed in the sinus region.

Commentary

These observations indicate a significant resorption of iliac grafts. Some authors advocate other sites for the source of the grafts or the use of biomaterials to improve the results. The high level of failure is linked to the collection of bone and the simultaneous placement of the implants, the initial stability of which is more difficult to obtain than with the two stage technique.