Dental implants have a good predictability in a large range of treatment options because of improvements in implant surface and implant design and a better understanding of soft and hard tissue biology. First-generation dental implants resulted in unacceptably high failure rates. The introduction of the second-generation surface, however, has improved implant survival rates in such a way that comparable results are obtained regardless of loading time or surgical protocol, though treatment of the maxilla and especially the posterior zone has always been subject to higher implant failure rates because of bone morphology, bone quality, and anatomical limitations. To overcome these drawbacks, bone grafting procedures and sinus elevation have been advocated. In this lecture, the overall clinical outcome of implants in the maxilla will be discussed; the scientific evidence regarding short- and wide-body implants will be reviewed as possible alternatives to sinus elevation or bone grafting; and recent clinical studies on immediate loading under compromised conditions, including human histologic data on immediate loading in conjunction with sinus elevation, will be reported.
Hugo De Bruyn, PhD, received his dental degree from the University of Leuven in Belgium, his PhD at the State University of Groningen in the Netherlands, and a master’s degree in periodontology at Lund University in Sweden. He worked in his own referral center for periodontology and implantology in Brussels for more than 15 years. Since 2004, he has been a professor and chairman of the Department of Periodontology and Oral Implantology at the University of Ghent in Belgium. He is the course director of the Postgraduate Oral Implant Program and the Postgraduate Specialist Program of Periodontology. Dr De Bruyn is also currently a visiting professor at the Department of Prosthodontics at Malmö University in Sweden.
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