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European Journal of Oral Implantology

Editor in Chief: Dr. Marco Esposito

Official publication of the British Society of Oral Implantology (BSOI), Italian Society of Oral Surgery and Implantology (SICOI), Danish Society for Oral Implantology (DSOI), German Association of Oral Implantology (DGI), Spanish Society of Implantology (SEI), British Academy of Implant & Restorative Dentistry (BAIRD) and Advanced Dental Implant Research & Education Center (AIC)

ISSN (print) 1756-2406 • ISSN (online) 1756-2414


Summer 2013
Volume 6 , Issue 2

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1-stage versus 2-stage lateral maxillary sinus lift procedures: 4-month post-loading results of a multicenter randomised controlled trial

Felice, Pietro / Pistilli, Roberto / Piattelli, Maurizio / Soardi, Elisa / Pellegrino, Gerardo / Corvino, Valeria / Esposito, Marco

Pages: 153-165
PMID: 23926587

Purpose: To compare the efficacy of 1-stage versus 2-stage lateral maxillary sinus lift procedures.
Materials and methods: Sixty partially edentulous patients requiring 1 to 3 implants and having 1 to 3 mm of residual bone height and at least 5 mm of bone width below the maxillary sinus, as measured on CT scans, were randomised into two equal groups to receive either a 1-stage lateral window sinus lift with simultaneous implant placement or a 2-stage procedure with implant placement delayed by 4 months using a bone substitute in 3 different centres. Implants were submerged for 4 months and loaded with reinforced provisional prostheses, which were replaced, after 4 months, by definitive prostheses. Outcome measures were augmentation procedure failures, prosthesis failures, implant failures, complications and marginal peri-implant bone loss assessed by a blinded outcome assessor. Patients were followed up to 4 months after loading. Only data of implants placed in 1 to 3 mm of bone height were reported.
Results: Two patients dropped out from the 1-stage group and none from the 2-stage group. No sinus lift procedure failed in the 1-stage group but 1 failed in the 2-stage group, the difference was not statistically significant (P = 1.00). Two prostheses failed or could not be placed in the planned time in the 1-stage group and 1 in the 2-stage group, the difference was not statistically significant (P = 0.51). Three implants failed in 3 patients of the 1-stage group versus 1 implant in the 2-stage group, the difference was not statistically significant (P = 0.28). Two complications occurred in the 1-stage group and 1 in the 2-stage group, the difference was not statistically significant (P = 0.61). There were no statistically significant differences in bone loss between groups at loading (0.05 mm). Sites treated in 1 stage lost an average of 0.56 mm (SD: 0.36; 95% CI: -0.70 to -0.42; P < 0.001) of peri-implant bone and 2-stage sites approximately 0.61 mm (SD: 0.34; 95% CI: -0.74 to -0.48; P < 0.001).
Conclusions: No statistically significant differences were observed between implants placed according to 1- or 2-stage sinus lift procedures. However, this study may suggest that in patients having a residual bone height between 1 and 3 mm below the maxillary sinus there might be a slightly higher risk for implant failures when performing a 1-stage lateral sinus lift procedure.

Keywords: anorganic bovine bone, dental implant, sinus lift, surgical procedures

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