Checchi Luigi, Felice Pietro, Antonini Elisa Soardi, Cosci Ferdinando, Pellegrino Gerardo, Esposito Marco
Department of Periodontology and Implantology, University of Bologna, Bologna, Italy.
Eur J Oral Implantol. 2010 Autumn;3(3):221-32.
To compare the effectiveness of two different techniques to lift the maxillary sinus via a crestal approach: the Summers versus the Cosci technique.
Fifteen partially edentulous patients missing bilaterally maxillary molars and/ or premolars having 4 to 7 mm of residual crestal height and at least 5 mm thickness below the maxillary sinuses measured on computed tomography scans were randomised to have implants placed in sinuses crestally lifted according to the Cosci or Summers technique with bone substitutes according to a split-mouth design. Implants were left to heal submerged for 6 months. Implants were loaded with acrylic provisional crowns/prostheses. Screw-retained definitive metal-ceramic prostheses were delivered 4 months after provisional loading. Outcome measures were prosthesis and implant failures, any complications, operation time, operator preference, and patient preference assessed 1 month after surgery and 1 month after delivery of the final prostheses by a blinded outcome assessor. All patients were followed up to 5 months after loading (1 year after implant placement).
Nineteen study implants were placed according to each technique. No patient dropped out and no implant failed. No discomfort/complications occurred at sites treated with the Cosci technique whereas 12 patients reported discomfort during the augmentation procedure at the side treated with the Summers technique, this was statistically significant, and in one of these patients a perforation of the sinus membrane occurred. Postoperatively, headache was reported by nine patients and swelling occurred in three of these patients at the Summers treated sides. Statistically significantly less time was required to place implants according to the Cosci technique (33 versus 24 minutes, on average). The two operators and 14 out of 15 patients preferred the Cosci technique.
Both crestal sinus lift techniques were successful but the Cosci technique required less surgical time, produced less intra- and postoperative morbidity and was preferred by patients.
比较两种不同的经牙槽嵴顶入路上颌窦提升技术的有效性：萨默斯技术与科斯基技术。
15例双侧上颌磨牙和/或前磨牙缺失的部分牙列缺损患者，在计算机断层扫描上测量其牙槽嵴顶剩余高度为4至7毫米，上颌窦下方至少5毫米厚，根据分口设计随机分为两组，分别采用科斯基技术或萨默斯技术联合骨替代材料经牙槽嵴顶提升上颌窦后植入种植体。种植体埋入愈合6个月。用丙烯酸临时冠/修复体加载种植体。临时加载4个月后交付螺丝固位的最终金属烤瓷修复体。结果指标包括修复体和种植体失败情况、任何并发症、手术时间、术者偏好以及患者偏好在术后1个月和最终修复体交付后1个月由盲法结果评估者进行评估。所有患者随访至加载后5个月（种植体植入后1年）。
每种技术各植入19枚研究种植体。无患者退出，无种植体失败。采用科斯基技术治疗的部位未出现不适/并发症，而12例患者在采用萨默斯技术治疗的一侧进行增量手术时报告有不适，差异有统计学意义，其中1例患者发生了窦膜穿孔。术后，9例患者报告有头痛，其中3例在采用萨默斯技术治疗的一侧出现肿胀。采用科斯基技术植入种植体所需时间在统计学上显著更短（平均33分钟对24分钟）。两名术者和15例患者中的14例更喜欢科斯基技术。
两种牙槽嵴顶上颌窦提升技术均成功，但科斯基技术所需手术时间更少，术中和术后发病率更低，且更受患者青睐。
