Nedir Rabah, Bischof Mark, Vazquez Lydia, Szmukler-Moncler Serge, Bernard Jean-Pierre
Swiss Dental Clinics Group, CdR Clinique de Soins Dentaires, Vevey, Switzerland.
Clin Oral Implants Res. 2006 Dec;17(6):679-86. doi: 10.1111/j.1600-0501.2006.01264.x.
The aim of the present pilot study was to evaluate: (1) the predictability of an osteotome sinus floor elevation procedure with ITI-SLA implants without placing a bone grafting material, and (2) the possibility to gain bone height without filling the created space with a bone grafting material.
Seventeen patients received 25 implants protruding in the sinus. Most implants (21/25) were 10 mm long, eight were inserted in type 2 bone, 12 in type 3 and five in type 4 bone. At implant placement, the mean residual bone height (RBH) under the maxillary sinus was 5.4+/-2.3 mm; it was 5.7+/-2.6 mm on the mesial side and 5.1+/-1.9 mm on the distal side. Nineteen implants had less than 6 mm of bone on at least one side and six implants had less than 6 mm on both sides. A healing period of 3-4 months was allowed before abutment tightening at 35 Ncm. The percentage of stable implants at abutment tightening and at the 1-year control was calculated. The endo-sinus bone gain and the crestal bone loss (CBL) at the mesial and distal sides were measured.
Abutments were tightened after 3.1+/-0.4 months. All implants but one (96%) resisted the applied 35 Ncm torque. At the 1-year control, all implants were clinically stable and supported the definitive prosthesis. All showed endo-sinus bone gain; the mean gain was 2.5+/-1.2 mm. The mean CBL was 1.2+/-0.7 mm. Endo-sinus bone gain and RBH showed a strong negative correlation (r=-0.78 on the mesial side and -0.80 on the distal side). A good correlation (r=0.73) was found between implant penetration in the sinus and endo-sinus bone gain.
Elevation of the sinus membrane alone without addition of bone grafting material can lead to bone formation beyond the original limits of the sinus floor. Despite a limited RBH at implant placement, a healing period of 3 months was sufficient to resist a torque of 35 N cm and to lead to a predictable implant function at the 1-year control.
本初步研究的目的是评估：（1）在不植入骨移植材料的情况下，使用ITI-SLA种植体进行骨凿上颌窦底提升术的可预测性；（2）在不使用骨移植材料填充所形成空间的情况下增加骨高度的可能性。
17例患者接受了25枚突出于上颌窦的种植体植入。大多数种植体（21/25）长度为10mm，8枚植入2型骨，12枚植入3型骨，5枚植入4型骨。植入种植体时，上颌窦下方的平均剩余骨高度（RBH）为5.4±2.3mm；近中侧为5.7±2.6mm，远中侧为5.1±1.9mm。19枚种植体至少一侧的骨量少于6mm，6枚种植体两侧的骨量均少于6mm。在以35Ncm的扭矩拧紧基台之前，给予3 - 4个月的愈合期。计算拧紧基台时及1年随访时种植体稳定的百分比。测量上颌窦内骨增量以及近中侧和远中侧的嵴顶骨吸收（CBL）。
在3.1±0.4个月后拧紧基台。除1枚种植体（96%）外，所有种植体均能承受35Ncm的施加扭矩。在1年随访时，所有种植体临床稳定并支持最终修复体。所有种植体均显示上颌窦内骨增量；平均增量为2.5±1.2mm。平均CBL为1.2±0.7mm。上颌窦内骨增量与RBH呈强负相关（近中侧r = -0.78，远中侧r = -0.80）。种植体在上颌窦内的植入深度与上颌窦内骨增量之间存在良好的相关性（r = 0.73）。
仅提升上颌窦膜而不添加骨移植材料可导致上颌窦底超出原始界限的骨形成。尽管植入种植体时RBH有限，但3个月的愈合期足以承受35Ncm的扭矩，并在1年随访时实现可预测的种植体功能。
