Clinical Outcome of One-Step Implant Therapy in the Severely Atrophic Posterior Maxilla: A 4- to 16-Year Retrospective Study.

PURPOSE: To evaluate the efficacy of one-step lateral sinus floor elevation (LSFE) in patients with severely atrophic posterior maxillae and to identify the accompanying risk factors for peri-implantitis.

MATERIALS AND

METHODS

In this long-term retrospective case series study, clinical data were obtained from the Periodontic Department at Taipei Tzu Chi Hospital. The one-step, nonsubmerged LSFE procedure enabled simultaneous implant placement in sites with a residual bone height (RBH) < 5 mm. In total, 54 patients and 65 sinuses received 107 implants to support fixed reconstructions over a period of 4 to 16 years. Healing abutments were simultaneously placed at the time of implant placement. Clinical and radiographic outcomes were assessed, including marginal bone loss (MBL) and implant survival rates. Information on all implants and patients were recorded. Univariate and multivariate analyses were performed via the generalized estimating equation method to assess possible patient- and implant-related risk factors for MBL and peri-implantitis.

RESULTS

The overall implant survival rate was 97.2%. A total of 29 implants (27%) had MBL > 0.5 mm. A history of periodontitis was not significantly associated with MBL (P > .05). Poor oral hygiene (P < .001), diabetes (P = .010), or a keratinized mucosa width < 2 mm (P = .011) were identified as potential risk factors for peri-implantitis.

CONCLUSIONS

This study demonstrates that, with careful case selection and adherence to proper implant protocols, one-step implant placement in severely atrophic maxillary sinuses using the LSFE procedure is predictable and can be maintained long-term.