Int J Oral Maxillofac Implants. 2020 Mar/Apr;35(2):415-422. doi: 10.11607/jomi.7950.
The aim of this study was to assess the radiographic and clinical outcomes of extra-short implants either alone or in conjunction with osteotome sinus floor elevation and to compare these with regular-sized implants in the posterior atrophic maxilla.
Systemically healthy, nonsmoker individuals having at least one tooth gap in the posterior maxilla were included in the study. When the residual bone height was < 4 mm, an extra-short implant (4 to 6 mm) in conjunction with osteotome sinus floor elevation was placed; when the residual bone height was between 4 and 7 mm, an extra-short implant alone was placed; and when it was ≥ 8 mm, a regular implant (8 to 10 mm) was placed. The implants were uncovered at 4 months, and porcelain-fused-to-metal crowns were fabricated. Crestal bone level, change in the crestal bone level, crown-to-implant ratio, and residual bone height were measured at baseline and 6 and 18 months postloading.
Thirty patients (15 men, 15 women, age range: 30 to 73 years) received 80 implants. One implant in the extra-short implant (n = 27 implants) and regular implant (n = 24 implants) groups and two implants in the extra-short implant with osteotome sinus floor elevation group (n = 29 implants) failed before loading. Crestal bone level was significantly higher in the regular implant group compared with the extra-short implant with osteotome sinus floor elevation group at 18 months (P < .028). Crestal bone level change between 6 and 18 months was significantly lower in the extra-short implant + osteotome sinus floor elevation group compared with the regular implant group (P = .003). There was no correlation between the crestal bone level, crestal bone level change, and prosthetic and implant characteristics (P > .05).
Extra-short implants placed either in native bone or in conjunction with osteotome sinus floor elevation may provide similar clinical and radiographic outcomes that are comparable to those obtained with regular implants. Both extra-short implant placement methods can be promising noninvasive treatment options for the posterior maxilla, and implant dimension, crown length, crown-to-implant ratio, and residual bone height may not affect the crestal bone level change, at least in the short term.
本研究旨在评估单独使用或联合使用骨凿窦底提升术的超短种植体的影像学和临床效果，并将其与后牙区萎缩上颌骨中的常规尺寸种植体进行比较。
本研究纳入了系统健康、不吸烟且在后牙区至少有一个牙间隙的个体。当剩余骨高度<4mm 时，植入超短种植体（4-6mm）并联合使用骨凿窦底提升术；当剩余骨高度在 4-7mm 之间时，单独植入超短种植体；当剩余骨高度≥8mm 时，植入常规种植体（8-10mm）。种植体在 4 个月时暴露，制作烤瓷熔附金属冠。在基线、加载后 6 个月和 18 个月时测量牙槽嵴顶骨水平、牙槽嵴顶骨水平变化、冠-植体比和剩余骨高度。
30 名患者（15 名男性，15 名女性，年龄范围：30-73 岁）共植入 80 枚种植体。在超短种植体（n=27 枚种植体）和常规种植体（n=24 枚种植体）组各有 1 枚种植体以及超短种植体联合骨凿窦底提升组（n=29 枚种植体）中有 2 枚种植体在加载前失败。在 18 个月时，常规种植体组的牙槽嵴顶骨水平明显高于超短种植体联合骨凿窦底提升组（P<0.028）。超短种植体联合骨凿窦底提升组在 6-18 个月间的牙槽嵴顶骨水平变化明显低于常规种植体组（P=0.003）。牙槽嵴顶骨水平、牙槽嵴顶骨水平变化与修复体和种植体特征之间无相关性（P>0.05）。
单独植入或联合使用骨凿窦底提升术的超短种植体可能提供类似的临床和影像学效果，与常规种植体相当。两种超短种植体植入方法都可能是后牙区非侵入性的治疗选择，并且种植体尺寸、冠长、冠-植体比和剩余骨高度至少在短期内不会影响牙槽嵴顶骨水平的变化。
