Department of Periodontology and Implantology, University of Bologna, Bologna, Italy.
J Periodontol. 2013 Aug;84(8):1039-47. doi: 10.1902/jop.2011.100684.
Various sinus-lift techniques have been described in the literature. The aim of this retrospective study is to evaluate the efficacy of a transalveolar sinus-lift technique in terms of implant survival, marginal bone loss, and complications.
A total of 538 patient records were examined, and after applying exclusion and inclusion criteria, a sample of patients was included with a mean follow-up of 5 years. Implants with a smooth or tapered surface were considered. Therefore, only sinus lifts with inorganic bovine bone matrix or demineralized bone matrix were included, and 1,536 periapical radiographs were analyzed. Outcome measures were implant success, implant failure (peri-implantitis and loss of osseointegration), marginal bone resorption, and biologic complications (membrane perforations, sinusitis, and intraoperative and/or postoperative hemorrhage). Periapical radiographs were evaluated before surgery, post-surgery, and after 6 months and 1, 3, and 5 years. We analyzed the residual crestal bone height under the sinus, the amount (mm) of height increase after surgery, and values of implant marginal bone resorption for considered follow-ups.
Two hundred eighty-two (282) patients were excluded. Therefore, 256 patients treated with the transalveolar sinus-lift technique were included. A total of 376 dental implants and 323 sinus lifts were analyzed. The overall rates of implant success and failure were 94.9% and 5.1%, respectively. The mean bone loss around implants was 1.98 mm (mean follow-up of 5 years). Patients treated with inorganic bovine bone matrix showed a better implant success rate (P = 0.03) than did patients treated with demineralized human matrix. Three Schneiderian membrane perforations occurred in the 323 sinus lifts. In these cases, the surgeon performed another surgical operation after 3 months. Postoperative complications were peri-implantitis (six cases) and osseointegration losses (13 cases).
The transalveolar sinus-lift technique was a safe, minimally invasive technique with an implant success rate comparable to traditional implantology. The implant success rate was positively affected by the low-resorption graft material, and a low bone-resorption rate around implants was found.
文献中已经描述了各种窦底提升技术。本回顾性研究旨在评估经牙槽窦底提升技术在种植体存活率、边缘骨丧失和并发症方面的疗效。
共检查了 538 例患者记录，在应用排除和纳入标准后，纳入了一组平均随访时间为 5 年的患者。使用表面光滑或锥形的种植体。因此，仅纳入使用无机牛骨基质或脱矿骨基质的窦底提升术，共分析了 1536 张根尖片。主要观察指标包括种植体成功、种植体失败（种植体周围炎和骨整合丧失）、边缘骨吸收和生物学并发症（膜穿孔、鼻窦炎和术中及/或术后出血）。在术前、术后、术后 6 个月以及 1、3 和 5 年时拍摄根尖片。我们分析了窦下剩余的牙槽嵴骨高度、术后增加的高度（mm）以及考虑的随访时间的种植体边缘骨吸收值。
排除了 282 例患者。因此，共纳入了 256 例接受经牙槽窦底提升技术治疗的患者。共分析了 376 颗种植体和 323 例窦底提升术。种植体的总成功率和失败率分别为 94.9%和 5.1%。种植体周围的平均骨损失为 1.98mm（平均随访时间为 5 年）。使用无机牛骨基质的患者的种植体成功率（P=0.03）优于使用脱矿人基质的患者。323 例窦底提升术中发生 3 例希氏膜穿孔。在这些情况下，外科医生在 3 个月后进行了另一次手术。术后并发症包括种植体周围炎（6 例）和骨整合丧失（13 例）。
经牙槽窦底提升技术是一种安全、微创的技术，其种植体成功率与传统种植学相当。种植体成功率受到低吸收移植物材料的积极影响，且种植体周围的骨吸收率较低。
