Kakar Ashish, Sripathi Rao Bappanadu H, Deshpande Nikhil, Hegde Shashikanth, Kohli Anil, Patney Aditya, Mahajan Harsh
Department of Periodontics, Yenepoya University Dental College, Mangalore, Karnataka; Senior Consultant, Department of Dentistry, Indraprastha Apollo Hospitals, New Delhi, India.
Department of Periodontics, Yenepoya University Dental College, Mangalore, Karnataka, India.
Indian J Dent Res. 2021 Jan-Feb;32(1):61-68. doi: 10.4103/ijdr.IJDR_857_19.
To assess osteotome-mediated sinus floor elevation (OMSFE) with simultaneous implant placement using an in situ hardening biphasic calcium phosphate (BCP) compared to xenograft as a control.
Patient in need for sinus floor augmentation in one or both sinuses were selected for this randomised controlled clinical trial. Sites presenting a residual sinus floor height of 3-6 mm and eligible for OMSFE were randomly assigned to receive either BCP (test) or xenograft particles (control). CBCT scans were performed before and at the time of implant loading (180 days). The difference in sinus floor height gain between the two groups was set as the primary endpoint parameter for equivalence testing. The implant insertion torque (ITV) was recorded and Implant stability quotients (ISQ) was assessed upon implant placement, abutment connection (160 days) and implant loading (180 days).
A total of 54 sinus lifts were performed in 42 patients including 12 bilateral cases. Four implants failed (two in each group) and a total of six patients were lost to follow-up. Statistical analysis of sinus floor height revealed no significant differences (p < 0.05) between groups at baseline nor at 180 days after augmentation. There was no statistical difference in sinus floor height gain between the two groups as supported by the 90% confidence intervals of the difference between groups. Good primary implant stability was confirmed in both treatment groups by ITV and ISQ measurements.
Within the limits of this study, it can be concluded that OMSFE using in situ hardening BCP particles results in equivalent sinus floor height gain than using xenograft particles but offers an easier application.
评估与作为对照的异种骨移植相比,使用原位硬化双相磷酸钙(BCP)进行骨凿介导的上颌窦底提升术(OMSFE)并同期植入种植体的效果。
选择需要一侧或双侧上颌窦底增高的患者进行这项随机对照临床试验。将剩余上颌窦底高度为3 - 6 mm且适合进行OMSFE的部位随机分配,分别接受BCP(试验组)或异种骨移植颗粒(对照组)。在种植体植入前及植入后180天进行CBCT扫描。两组之间上颌窦底高度增加的差异被设定为等效性检验的主要终点参数。记录种植体植入扭矩(ITV),并在种植体植入时、基台连接时(160天)和种植体加载时(180天)评估种植体稳定性商数(ISQ)。
42例患者共进行了54次上颌窦提升术,包括12例双侧病例。4枚种植体失败(每组2枚),共有6例患者失访。上颌窦底高度的统计分析显示,基线时及增高后180天两组之间均无显著差异(p < 0.05)。两组之间上颌窦底高度增加无统计学差异,这得到了两组差异的90%置信区间的支持。通过ITV和ISQ测量证实两个治疗组的种植体初期稳定性良好。
在本研究的范围内,可以得出结论,使用原位硬化BCP颗粒进行OMSFE与使用异种骨移植颗粒相比,可使上颌窦底高度获得等效增加,但应用起来更简便。