Clinical application of implant-supported rehabilitation with osteotome sinus floor elevation without bone grafting and simultaneous implant placement

Objective: To study the clinical effect of osteotome sinus floor elevation (OSFE) without bone grafting combined with simultaneous implant placement in the treatment of edentulous posterior maxilla subject to insufficient bone height.

Methods: Sixty-seven Straumann SLA implants were placed in the posterior maxilla in 50 patients. The residual bone height (RBH) was (5.2+/-2.2)mm. The procedure of OSFE without bone grafting was applied. The final prostheses were restored after 3 to 6 months. The stability and osseointegration of the implants were clinically evaluated, also the endo-sinus bone gain around the implants were measured. The follow-up period was (12.8+/-5.6)months.

Results: The survival rate was 97.01% during the study period. 65 out of the 67 implants were clinically stable and were loaded without pain or any subjective sensation. 4 implants had detectable sinus membrane perforation during operation. The radiographic results demonstrated that the endo-sinus bone gain was (2.5+/-1.3) mm and the marginal bone loss (MBL) was (1.1+/-0.7)mm.

Conclusions: OSFE alone with no grafting could yield predictable clinical results for atrophic edentulous posterior maxillary region. It may be feasible even with RBH less than 4 mm.