RESUMEN
OBJECTIVE: To compare implant survival, marginal bone loss, peri-implant clinical parameters, and complications in dental implants placed in the posterior maxilla in native bone or after grafting using the open sinus lift technique. MATERIALS AND METHODS: A search was made of two electronic databases (MEDLINE via PubMed and the Cochrane Oral Health Group Trials Register [CENTRAL]), complemented by a manual search. The study included randomized clinical trials, non-randomized clinical trials, and observational studies such as cohort studies and case-control studies conducted on a prospective or retrospective basis and comparing the placement of standard length implants (≥ 10 mm) in native bone or after grafting using the sinus lift procedure. Risk of bias was evaluated with the Cochrane risk of bias assessment tool and the methodological index for non-randomized studies (MINORS). RESULTS: The search yielded 90 studies, of which 23 were included. Two studies were evaluated with the Cochrane risk of bias assessment tool, with neither being identified as presenting low risk of bias. Twenty-one studies were evaluated by the MINORS, yielding a mean score of 15.66 points out of 24. The implant survival rate in the control group was 90% to 100% versus 75.3% to 100% in the test group over a follow-up period of 6 to 120 months. Most studies revealed no statistically significant differences. In most of the publications, marginal bone loss was greater in the test group than in the control group, though without reaching statistical significance. Similar results were obtained in both groups with regard to the peri-implant clinical parameters. There were more surgical complications in the test group than in the control group-such complications being inherent to the sinus lift procedure. CONCLUSION: Implant placement after sinus lift affords results in terms of implant survival, marginal bone loss, and peri-implant clinical parameters similar to those obtained with conventional implant placement in native bone. However, there is a greater incidence of surgical complications associated with the sinus lift procedure.
Asunto(s)
Implantes Dentales , Maxilar , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Estudios Prospectivos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
BACKGROUND: To compare the radiological parameters and success of posterior maxillary direct sinus lift with simultaneous or delayed implant placement, or implant placement in native bone, after a minimum follow-up period of 5 years. MATERIAL AND METHODS: A retrospective cohort study was carried out in a university clinic, selecting patients subjected to implant treatment in the posterior maxilla between the years 2005 and 2011. The patients were divided into three groups: 1) implants placed in native bone; 2) direct sinus lift with simultaneous implant placement; and 3) direct sinus lift with delayed implant placement. Bone crest level, bone loss, vertical bone gain, and implant success and survival after a minimum follow-up period of 5 years after prosthetic loading were analyzed. RESULTS: A total of 163 patients and 329 implants were included in the study. The mean duration of follow-up was 7.0 ± 1.9 years. Bone loss and implant success and survival were very similar in all three groups, with no significant differences among them. Graft reabsorption was greatest during the first 12 months, though graft stabilization was confirmed after 5 years of follow-up. CONCLUSIONS: Bone loss and percentage success and survival proved very similar for the implants placed in native bone and for sinus lift with simultaneous or delayed implant placement. The height of the graft material decreased mainly in the first 12 months, and continued until stabilization after 5 years, with no significant variations thereafter.