RESUMEN
BACKGROUND: Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable with those placed in non-augmented sites. Flapless implant surgery can minimize postoperative morbidity, alveolar bone resorption and crestal bone loss. The use of cone beam computerized tomography (CBCT) provides 3D presentations with reduced dose exposure. OBJECTIVES: To evaluate a flapless, CBCT-guided transalveolar sinus floor elevation technique with simultaneous implant installation. MATERIAL AND METHODS: Fourteen consecutive patients in need of maxillary sinus floor augmentation were enrolled in this study. Preoperative CBCT with a titanium screwpost as an indicator at the intended implant position was used to visually guide the flapless surgical procedure. Twenty one implants all with a length of 10 mm and a diameter of 4.1 and 4.8 mm were inserted and followed clinically and with CBCT for 3, 6 and 12 months postoperatively. Intraoral radiographs were taken for comparison. All patients were provided with permanent prosthetic constructions 8-12 weeks after implant surgery. RESULTS: Ten (47.6%) implants were inserted in residual bone of 2.6-4.9 mm and 11 (52.3%) implants were inserted in residual bone of 5-8.9 mm. No implants were lost after surgery and follow-up. There was no marginal bone loss during the follow-up verified by CBCT. The implants penetrated on average 4.4 mm (SD 2.1 mm) into the sinus cavity and the mean bone gain was 3 mm (SD 2.1 mm). CONCLUSION: Flapless transalveolar sinus lift procedures visually guided by preoperative CBCT can successfully be used to enable placement, successful healing and loading of one to three implants in residual bone height of 2.6-8.9 mm. There was no marginal bone loss during the 3-12 months follow-up.
Asunto(s)
Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Procedimientos Quirúrgicos Preprotésicos Orales/métodos , Elevación del Piso del Seno Maxilar/métodos , Adulto , Anciano , Femenino , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
PURPOSE: The purpose of this study was to investigate the clinical and radiographic outcome of a prospective 5-year longitudinal multicenter test of a simplified implantology concept comprising an abutment-free implant system (Cresco) and a new method for fabrication of passively fitting superstructures, the Cresco Ti Precision method. MATERIALS AND METHODS: The tests were carried out at three different centers. Sixty partially or completely edentulous patients were restored by fixed implant-supported superstructures fabricated according to the Cresco Ti Precision method. In all, 215 Cresco implants were placed for the support of the superstructures. For various reasons, eight patients (13%) could not be followed through the 5 years. The radiographic measurements were recorded from radiographs exposed perpendicular to the implants. RESULTS: The initial implant failure rate (during the healing phase) was 2%, and the survival rate after loading was 98%. The mean peri-implant bone loss was 0.29 mm (SD 0.57). Of the measured sites, 71% showed a crestal bone loss of less than 0.5 mm. Very few mechanical complications were observed. This was attributed to the passively fitting superstructures. CONCLUSION: The results from the present multicenter test demonstrated that the abutment-free Cresco implantology concept is a reliable alternative method for implant-supported fixed prosthetic rehabilitation of edentulous and partially edentulous jaws.