The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
권호 표지

A Retrospective study of the Cumulative Survival Rate and change of peri-implant marginal bone around implants associated with maxillary sinus augmentation

상악동 골 이식술을 동반하여 식립된 임플란트의 변연골변화와 생존률에 관한 후향적 연구

  • Ryu, Hwa-Suk (Department of Implant Dentistry, Graduate School of Clinical Dentistry, Ewha Womans University) ;
  • Kim, Sun-Jong (Department of Implant Dentistry, Graduate School of Clinical Dentistry, Ewha Womans University) ;
  • Park, Eun-Jin (Department of Prosthodontics, Graduate School of Clinical Dentistry, Ewha Womans University) ;
  • Kim, Myung-Rae (Department of Implant Dentistry, Graduate School of Clinical Dentistry, Ewha Womans University)
  • 유화숙 (이화여자대학교 임상치의학대학원 임플란트학과) ;
  • 김선종 (이화여자대학교 임상치의학대학원 임플란트학과) ;
  • 박은진 (이화여자대학교 의학전문대학원 치과보철과) ;
  • 김명래 (이화여자대학교 임상치의학대학원 임플란트학과)
  • Published : 2009.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Statement of problem: Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone & bone substitute graft has been proven to be a reliable treatment modality, at least in the short term. The aim of this study is to evaluate the factors of implant survival rate associated with maxillary sinus lift with grafts. Material and methods: The sinus floor was augmented with bone grafts derived from modified Caldwell-luctechnique(71 subject, 93 sinus, 180 implants), the autogenous bone or autogenous+Bio-oss. Before implant installation the width and height of the alveolar crest were increased in the first stage procedure in 10 patients while in the other 61 patients augmentation and implant installation could be performed simultaneously width and height of the alveolar crest > 4 mm) or delayed installation. Results: In all case bone volume was sufficients for implant insertion. 14 of 180 inserted implants were lost during follow up and the healing period Patient received implant supported overdenture(5 patients) or fixed bridge(62 patients). Conclusion: Within the limit of the result of this study, we conclude that bone grafting of the floor of the maxillary sinus floor with bone for the insertion of implants might be a reliable treatment modality and the autogenous bone graft and delayed installation method might be the factors for good results.

연구목적: 이 연구는 측방접근법을 통해 상악동 골이식을 시행한 후 임플란트를 식립하였을 때, 누적 생존률 및 성별, 연령별, 이식재, 자가골의 공여부, 술전 잔존골 양, 무치악 형태, 식립 시기, 임플란트 종류, 직경과 길이에 따른 임플란트의 생존률 및 변연골의 방사선학적 결과의 차이를 분석하고자 시행되었다. 연구 재료 및 방법: 상악 구치에 측방접근법을 통해 상악동 골이식술 후 임플란트 보철치료를 시행한 71명을 대상으로 하였으며 표면 처리된 나사모양의 임플란트를 사용하였다. Osseotite(BIOMET 3i, Warsaw, USA), Neoplant(Neobiotec, Seoul, Korea), $Br\ddot{a}nemark$(Nobel Biocare, Goteberg, Sweden)과 SSII(Osstem, Busan, Korea)를 사용하였다. 최소 6개월 이상의 기간 관찰 누적 생존률은 Kaplan-Meier 분석법을 이용하였으며 다른 요소에 따른 임플란트의 생존률의 유의성은 Chi-square test로 검정하였다. 결과: 상악동골 이식술이 시행된 모든 증례에서 임플란트 식립이 가능한 골 양이 얻어졌으며 92%의 생존률을 보였다. 결론: 상악동 골이식술을 시행한 후 임플란트 보철 수복은 자가골 단독 사용시에 자가골과 골대체 물질이 혼합된 것보다 우수한 생존률을 보였다. 지연 식립하는 경우가 임플란트와 동시에 식립하는 경우보다 생존률이 높았다.

Keywords

References

  1. Jemt T, Lekholm U, Adell R. Osseointegrated implants in the treatment of partially edentulous patients: a preliminary study on 876 consecutively placed fixtures. Int J Oral Maxillofac Implants 1989;4:211-7
  2. Ekfeldt A, Carlsson GE, Borjesson G. Clinical evaluation of single-tooth restorations supported by osseointegrated implants: a retrospective study. Int J Oral Maxillofac Implants 1994;9:179-83
  3. Baek JH, Kim MR., The prognosis of maxillary posterior implant installed with sinus augmentation simultaneously. Korean J Maxillofac Reconstr Surg 2001;10:23-30
  4. Tatum H, Jr. Maxillary and sinus implant reconstructions. Dent Clin North Am 1986;30:207-29
  5. Boyne PJ, Marx RE, Nevins M, Triplett G, Lazaro E, Lilly LC, et al. A feasibility study evaluating rhBMP-2 absorbable collagen sponge for maxillary sinus floor augmentation. Int J Periodontics Restorative Dent 1997;17:11-25
  6. Grunder U, Gaberthuel T, Boitel N, Imoberdorf M, Meyenberg K, Andreoni C, et al. Evaluating the clinical performance of the Osseotite implant: defining prosthetic predictability. Compend Contin Educ Dent 1999;20:628-33, 636, 638-40
  7. Zarb GA, Albrektsson T. Consensus report: towards optimized treatment outcomes for dental implants. J Prosthet Dent 1998;80:641 https://doi.org/10.1016/S0022-3913(98)70048-4
  8. Jensen OT, Shulman LB, Block MS, Iacono VJ. Report of the Sinus Consensus Conference of 1996. Int J Oral Maxillofac Implants 1998;13:11-45
  9. Tidwell JK, Blijdorp PA, Stoelinga PJ, Brouns JB, Hinderks F. Composite grafting of the maxillary sinus for placement of endosteal implants. A preliminary report of 48 patients. Int J Oral Maxillofac Surg 1992;21:204-9 https://doi.org/10.1016/S0901-5027(05)80219-X
  10. Blomqvist JE, Alberius P, Isaksson S. Two-stage maxillary sinus reconstruction with endosseous implants: a prospective study. Int J Oral Maxillofac Implants 1998;13:758-66
  11. Peleg M, Mazor Z, Garg AK. Augmentation grafting of the maxillary sinus and simultaneous implant placement in patients with 3 to 5 mm of residual alveolar bone height. Int J Oral Maxillofac Implants 1999;14:549-56
  12. Peleg M, Chaushu G, Mazor Z, Ardekian L, Bakoon M. Radiological findings of the post-sinus lift maxillary sinus: a computerized tomography follow-up. J Periodontol 1999;70:1564-73 https://doi.org/10.1902/jop.1999.70.12.1564
  13. Peleg M, Mazor Z, Chaushu G, Garg AK. Sinus floor augmentation with simultaneous implant placement in the severely atrophic maxilla. J Periodontol 1998;69:1397-403 https://doi.org/10.1902/jop.1998.69.12.1397
  14. Lazzara R, Siddiqui AA, Binon P, Feldman SA, Weiner R, Phillips R, et al. Retrospective multicenter analysis of 3i endosseous dental implants placed over a five-year period. Clin Oral Implants Res 1996;7:73-83 https://doi.org/10.1034/j.1600-0501.1996.070109.x
  15. Lee JB, Oung YS, Shin GH, Whang BN. Clinical results of AVANA implant system. J Korean Dent Assoc 2000: 38:23-28
  16. Valentini P, Abensur D. Maxillary sinus floor elevation for implant placement with demineralized freeze-dried bone and bovine bone (Bio-Oss): a clinical study of 20 patients. Int J Periodontics Restorative Dent 1997;17:232-41
  17. Moy PK, Lundgren S, Holmes RE. Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg 1993; 51:857-62 https://doi.org/10.1016/S0278-2391(10)80103-X
  18. Lekholm U, Zarb G. Patient selection and preparation. In: Branemark PI, Zarb G, T A, editors. Tissue integrated prostheses. Chicago: Quintessence; 1985
  19. Schwartz-Arad D, Samet N, Samet N, Mamlider A. Smoking and complications of endosseous dental implants. J Periodontol 2002;73:153-7 https://doi.org/10.1902/jop.2002.73.2.153
  20. Ivanoff C J, Grondahl k, Sennerby L, Bergstrom C, Leukholm U, Influence of variation in implant diameters: A 3-to-5- year retrospective clinical report. Int J Oral Maxillofac implants 1999;14:173-180
  21. Bragger U, Huber B, Lang N. Evaluation of postsurgical crest bone level adjacent to non-submerged dental implants. Clin Oral Implants Res 1998;9:218-24 https://doi.org/10.1034/j.1600-0501.1998.090402.x
  22. Albrektsson T, Zarb G, Warthington P, Eriksson AR. The long term efficacy of currently uesd dental implants: a review and proposed criteria of sucess. Int J Oral Maxillofac Implants 1986;1:11-25
  23. Jensen OT, Shulman LB, Block MS, Iacono VJ. Report of the Sinus Conference of 1996. Int J Oral Maxillofac Implants 1998:135-45
  24. Kent JN, Block MS. Simultaneous maxillary sinus floor bone grafting and placement of hydroxylapatite-coated implants. J Oral Maxillofac Surg 1989;47:238-42 https://doi.org/10.1016/0278-2391(89)90225-5
  25. Albrektsson T, IF. Consensus report in Session V. In: Lang N, Karring T. eds. Proceedings of the 1st European Workshop on Periodontology. London, Quintessence pp. 365-69
  26. Albrektsson T, Zarb GA. Current interpretations of the osseointegrated response: clinical significance. Int J Prosthodont 1993;6:95-105
  27. Misch CE, Suzuki JB, Misch-Dietsh FM, Bidez MW. A positive correlation between occlusal trauma and peri-implant bone loss: literature support. Implant Dent 2005;14:108-16 https://doi.org/10.1097/01.id.0000165033.34294.db