Corbella Stefano, Taschieri Silvio, Del Fabbro Massimo
Department of Biomedical, Surgical and Dental Sciences, Research Center in Oral Implantology, IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Università degli Studi di Milano, Milan, Italy.
Clin Implant Dent Relat Res. 2015 Feb;17(1):120-32. doi: 10.1111/cid.12077. Epub 2013 May 8.
The aim of the present systematic review was to estimate the implant survival rate in different types of techniques for the rehabilitation of posterior atrophic maxilla, after at least 3 years of follow-up.
MEDLINE database was searched using a combination of specific terms. A hand searching of the relevant journals and of the reference lists of systematic reviews was also performed. All retrospective and prospective studies evaluating short implants in posterior maxilla, osteotome sinus floor elevation and lateral approach sinus floor elevation, and having a follow-up of at least 3 years, were included.
Forty-four articles were included in the review. In four studies reporting on a total of 901 short implants, the implant survival rate varied from 86.5% to 98.2% with up to 5 years follow-up. For the osteotome technique, 1,208 implants in eight studies were considered, showing a survival rate varying from 95.4% to 100% after 3-year follow-up. Twenty-nine studies, accounting for 6,940 implants placed in 2,707 sinuses augmented through lateral technique were considered. Implant survival rate varied from 75.57% to 100%. Only three comparative studies were found that showed no significant difference in clinical outcomes between lateral approach and osteotome technique.
Sinus floor elevation with the lateral approach and with the osteotome technique is an effective and well-documented therapeutic option for the rehabilitation of atrophic posterior maxilla. The use of short implants is promising but needs further investigation to be considered as effective as the other techniques in the long term. However, the indication for the three different techniques is not perfectly equivalent and the treatment choice should be based on a careful evaluation of the individual case, in particular on the available residual bone.
本系统评价的目的是评估在至少3年的随访后，不同技术用于修复后牙区萎缩性上颌骨时种植体的存留率。
使用特定术语组合检索MEDLINE数据库。还对手检相关期刊以及系统评价的参考文献列表进行了检索。纳入所有评估后牙区短种植体、骨凿上颌窦底提升术和外侧入路上颌窦底提升术且随访至少3年的回顾性和前瞻性研究。
该评价纳入了44篇文章。在4项共报道901枚短种植体的研究中，随访长达5年时，种植体存留率在86.5%至98.2%之间。对于骨凿技术，8项研究中的1208枚种植体被纳入分析，3年随访后的存留率在95.4%至100%之间。29项研究共纳入了通过外侧技术在2707个上颌窦内植入的6940枚种植体，种植体存留率在75.57%至100%之间。仅发现3项比较研究，结果显示外侧入路和骨凿技术在临床效果上无显著差异。
外侧入路和骨凿技术进行上颌窦底提升术是修复萎缩性后牙区上颌骨的一种有效且有充分文献记载的治疗选择。短种植体的应用前景良好，但从长期来看，需要进一步研究以确定其与其他技术同样有效。然而，这三种不同技术的适应证并不完全等同，治疗选择应基于对个体病例的仔细评估，尤其是对可用剩余骨量的评估。
