State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin South Road, Chengdu, 610041, Sichuan, China.
Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Clin Oral Investig. 2023 Jul;27(7):3611-3626. doi: 10.1007/s00784-023-04974-8. Epub 2023 Apr 3.
This study aimed to analyze the effect of the apex coverage by the bone graft, including exposure and coverage less than or greater than 2 mm on implant survival rate and peri-implant bone and soft tissue remodeling.
A total of 264 implants in 180 patients who had undergone transcrestal sinus floor elevation (TSFE) with simultaneous implant placement were included in this retrospective cohort study. Radiographic assessment was used to categorize the implants into three groups based on apical implant bone height (ABH): ≤ 0 mm, < 2 mm, or ≥ 2 mm. The implant survival rate, peri-implant marginal bone loss (MBL) during short-term (1-3 years) and mid- to long-term (4-7 years) follow-up, and clinical parameters were used to evaluate the effect of implant apex coverage after TSFE.
Group 1 had 56 implants (ABH ≤ 0 mm), group 2 had 123 implants (ABH > 0 mm, but < 2 mm), and group 3 had 85 implants (ABH ≥ 2 mm). There was no significant difference in the implant survival rate between groups 2 and 3 compared to group 1 (p = 0.646, p = 0.824, respectively). The MBL during short-term and mid- to long-term follow-up indicated that apex coverage could not be considered a risk factor. Furthermore, apex coverage did not have a significant effect on other clinical parameters.
Despite limitations, our study found that implant apex coverage by the bone graft, including exposure and coverage levels less than or greater than 2 mm, did not significantly affect implant survival, short-term or mid- to long-term MBL, or peri-implant soft tissue outcomes.
Based on 1- to 7-year data, the study suggests that implant apical exposure and coverage levels of less than or greater than 2 mm bone graft are both valid options for TSFE cases.
本研究旨在分析骨移植覆盖种植体根尖的效果，包括暴露和覆盖小于或大于 2mm 对种植体存活率以及种植体周围骨和软组织重塑的影响。
本回顾性队列研究共纳入 180 名患者的 264 个种植体，这些患者均接受了经牙槽嵴顶窦底提升（TSFE）联合同期种植体植入手术。通过影像学评估，根据根尖种植体骨高度（ABH）将种植体分为三组：≤0mm、<2mm 或≥2mm。采用种植体存活率、短期（1-3 年）和中-长期（4-7 年）随访时的种植体边缘骨丧失（MBL）以及临床参数，评估 TSFE 后种植体根尖覆盖的效果。
第 1 组有 56 个种植体（ABH≤0mm），第 2 组有 123 个种植体（ABH>0mm，但<2mm），第 3 组有 85 个种植体（ABH≥2mm）。与第 1 组相比，第 2 组和第 3 组的种植体存活率无显著差异（p=0.646，p=0.824）。短期和中-长期随访时的 MBL 表明，根尖覆盖不能被视为危险因素。此外，根尖覆盖对其他临床参数也没有显著影响。
尽管存在局限性，但本研究发现，骨移植覆盖种植体根尖，包括暴露和覆盖水平小于或大于 2mm，并不显著影响种植体存活率、短期或中-长期 MBL 以及种植体周围软组织结局。
基于 1 至 7 年的数据，本研究表明，种植体根尖暴露和骨移植覆盖小于或大于 2mm 水平均为 TSFE 病例的有效选择。
