Marco Tallarico, David L Cochran, Erta Xhanari, Claudia Dellavia, Elena Canciani, Eitan Mijiritsky, Silvio Mario Meloni
{"title":"使用带内部l型通道的种植体提升嵴窦:一项前瞻性队列研究的结果。","authors":"Marco Tallarico, David L Cochran, Erta Xhanari, Claudia Dellavia, Elena Canciani, Eitan Mijiritsky, Silvio Mario Meloni","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and radiographic outcomes of a one-stage crestal sinus elevation procedure using a self-tapping endosseous implant system (iRaise, Maxillent, Herzliya, Israel) developed for sinus augmentation, 1 year after loading.</p><p><strong>Materials and methods: </strong>Patients needing restoration in the posterior maxilla with a residual alveolar crest of 3 to 8 mm in height and 5 mm in width distal to the canine as measured on CBCT scan were treated using the iRaise sinus lift system. Outcome measures were: implant and prosthetic failures, any complications, increased bone height (iBH), marginal bone loss (MBL), implant stability quotient (ISQ), radiographic tissue remodelling patterns using the sinus grafting remodelling index (SGRI), volumetric measurements of sinus graft, patient self-reported post-surgical swelling, consumption of pain medication and histological analysis.</p><p><strong>Results: </strong>A total of 30 consecutive participants with a mean age of 54.2 ± 9.4 years underwent a transcrestal elevation of the sinus membrane, insertion of bone graft, and implant placement. A total of 50 implants were placed (30 iRaise system implants and 20 adjunctive iSure implants, Maxillent). The mean follow-up was 15.8 ± 2.1 months after implant loading. One patient dropped out at the 1-year after loading follow-up examination. No implants and no prostheses failed during the entire follow-up. One patient experienced a small membrane tear. Before implant insertion, the mean residual alveolar ridge height was 4.64 ± 0.86 mm (range: 3.4-6.4 mm; 95% CI: 4.39-5.01 mm). One year after loading, the bone height was 16.86 ± 3.13 mm (95% CI 15.83-18.07 mm). At the 1-year after loading follow-up, the mean MBL was 0.19 ± 1.05 mm (95% CI 0.02-0.78 mm). The mean ISQ at implant placement was 65.2 ± 5.4 (95% CI 63.6-67.4) and increased during the healing period reaching the mean value of 73.6 ± 3.7 (95% CI 73.1-75.9; range 62-79). The difference was statistically significant (8.4 ± 5.3; 95% CI 5.9-39.7; P = 0.0000). One year after loading, SGRI score was evaluated in 23 implants. Overall, the mean SGRI value was 2.29 ± 2.41 mm (95% CI 1.22-2.98 mm). Bone volume at implant placement was 2.41 ± 0.25 CC (95% CI 2.22-2.48 CC). During the 6-month, submerged healing period, a slight bone contraction of 11.3% were observed. (2.13 ± 0.24 CC;95% CI 2.02-2.26; difference = 0.27 ± 0.25 CC; 95% CI 0.10-0.36; P = 0.0011). At the first year post-loading period, the bone graft remained stable (2.11 ± 0.22 CC; 95% CI 2.02-2.24). The difference was not statistically significant (0.02 ± 0.07 CC; 95% CI 0.01-0.04; P = 0.2166). From the patient's point of view, the mean pain value was 0.52 ± 0.74 (range 0-3); mean swelling value was 0.27 ± 0.52 (range 0-2); and the mean consumption of analgesic was 0.87 ± 4.94 tablets (range 0-4) 3 days after surgery. Morphological and histomorphometric analyses showed that all the samples had a normal structure without inflammatory infiltrate, six months after healing. The following fractions (%) were found: bone (immature bone + mature bone): 44.07 ± 4.91; residual biomaterial: 23.98 ± 2.64; medullary spaces: 31.95 ± 3.16.</p><p><strong>Conclusions: </strong>Sinus floor augmentation can be successfully accomplished with a transcrestal approach using a dedicated implant system. A physiologic contraction of 11.3% of the original volume of the bone graft was experienced during the first 6 months of healing; afterwards, no additional graft volume reduction was observed. Long-term clinical studies are needed to confirm these preliminary results.</p>","PeriodicalId":49259,"journal":{"name":"European Journal of Oral Implantology","volume":"10 3","pages":"325-336"},"PeriodicalIF":0.0000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Crestal sinus lift using an implant with an internal L-shaped channel: 1-year after loading results from a prospective cohort study.\",\"authors\":\"Marco Tallarico, David L Cochran, Erta Xhanari, Claudia Dellavia, Elena Canciani, Eitan Mijiritsky, Silvio Mario Meloni\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the clinical and radiographic outcomes of a one-stage crestal sinus elevation procedure using a self-tapping endosseous implant system (iRaise, Maxillent, Herzliya, Israel) developed for sinus augmentation, 1 year after loading.</p><p><strong>Materials and methods: </strong>Patients needing restoration in the posterior maxilla with a residual alveolar crest of 3 to 8 mm in height and 5 mm in width distal to the canine as measured on CBCT scan were treated using the iRaise sinus lift system. Outcome measures were: implant and prosthetic failures, any complications, increased bone height (iBH), marginal bone loss (MBL), implant stability quotient (ISQ), radiographic tissue remodelling patterns using the sinus grafting remodelling index (SGRI), volumetric measurements of sinus graft, patient self-reported post-surgical swelling, consumption of pain medication and histological analysis.</p><p><strong>Results: </strong>A total of 30 consecutive participants with a mean age of 54.2 ± 9.4 years underwent a transcrestal elevation of the sinus membrane, insertion of bone graft, and implant placement. A total of 50 implants were placed (30 iRaise system implants and 20 adjunctive iSure implants, Maxillent). The mean follow-up was 15.8 ± 2.1 months after implant loading. One patient dropped out at the 1-year after loading follow-up examination. No implants and no prostheses failed during the entire follow-up. One patient experienced a small membrane tear. Before implant insertion, the mean residual alveolar ridge height was 4.64 ± 0.86 mm (range: 3.4-6.4 mm; 95% CI: 4.39-5.01 mm). One year after loading, the bone height was 16.86 ± 3.13 mm (95% CI 15.83-18.07 mm). At the 1-year after loading follow-up, the mean MBL was 0.19 ± 1.05 mm (95% CI 0.02-0.78 mm). The mean ISQ at implant placement was 65.2 ± 5.4 (95% CI 63.6-67.4) and increased during the healing period reaching the mean value of 73.6 ± 3.7 (95% CI 73.1-75.9; range 62-79). The difference was statistically significant (8.4 ± 5.3; 95% CI 5.9-39.7; P = 0.0000). One year after loading, SGRI score was evaluated in 23 implants. Overall, the mean SGRI value was 2.29 ± 2.41 mm (95% CI 1.22-2.98 mm). Bone volume at implant placement was 2.41 ± 0.25 CC (95% CI 2.22-2.48 CC). During the 6-month, submerged healing period, a slight bone contraction of 11.3% were observed. (2.13 ± 0.24 CC;95% CI 2.02-2.26; difference = 0.27 ± 0.25 CC; 95% CI 0.10-0.36; P = 0.0011). At the first year post-loading period, the bone graft remained stable (2.11 ± 0.22 CC; 95% CI 2.02-2.24). The difference was not statistically significant (0.02 ± 0.07 CC; 95% CI 0.01-0.04; P = 0.2166). From the patient's point of view, the mean pain value was 0.52 ± 0.74 (range 0-3); mean swelling value was 0.27 ± 0.52 (range 0-2); and the mean consumption of analgesic was 0.87 ± 4.94 tablets (range 0-4) 3 days after surgery. Morphological and histomorphometric analyses showed that all the samples had a normal structure without inflammatory infiltrate, six months after healing. The following fractions (%) were found: bone (immature bone + mature bone): 44.07 ± 4.91; residual biomaterial: 23.98 ± 2.64; medullary spaces: 31.95 ± 3.16.</p><p><strong>Conclusions: </strong>Sinus floor augmentation can be successfully accomplished with a transcrestal approach using a dedicated implant system. A physiologic contraction of 11.3% of the original volume of the bone graft was experienced during the first 6 months of healing; afterwards, no additional graft volume reduction was observed. Long-term clinical studies are needed to confirm these preliminary results.</p>\",\"PeriodicalId\":49259,\"journal\":{\"name\":\"European Journal of Oral Implantology\",\"volume\":\"10 3\",\"pages\":\"325-336\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Oral Implantology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Dentistry\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Oral Implantology","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Dentistry","Score":null,"Total":0}
引用次数: 0
摘要
目的:评估使用自攻式骨内种植体系统(iRaise, Maxillent, Herzliya, Israel)进行一期嵴窦提升术的临床和影像学结果,该系统在加载后1年用于窦提升。材料和方法:需要修复后上颌的患者,在CBCT扫描测量到犬齿远端残留牙槽嵴高度为3 ~ 8mm,宽度为5mm,使用iRaise窦提升系统进行治疗。结果测量:种植体和假体失败,任何并发症,骨高度增加(iBH),边缘骨丢失(MBL),种植体稳定性商数(ISQ),使用窦移植重构指数(SGRI)的x线组织重构模式,窦移植体积测量,患者自我报告术后肿胀,止痛药消耗和组织学分析。结果:共有30名平均年龄为54.2±9.4岁的连续参与者接受了经瓣窦膜抬高、骨移植物插入和种植体放置。总共放置了50个种植体(30个raise系统种植体和20个辅助iSure种植体,Maxillent)。平均随访时间15.8±2.1个月。1例患者在加载随访检查1年后退出。在整个随访期间没有种植体和假体失败。一名患者出现小的膜撕裂。种植体植入前,平均残牙槽嵴高度为4.64±0.86 mm(范围:3.4-6.4 mm;95% CI: 4.39-5.01 mm)。加载1年后,骨高度为16.86±3.13 mm (95% CI 15.83 ~ 18.07 mm)。在加载随访1年后,平均MBL为0.19±1.05 mm (95% CI 0.02-0.78 mm)。种植体放置时的平均ISQ为65.2±5.4 (95% CI 63.6-67.4),在愈合期间增加,达到平均值73.6±3.7 (95% CI 73.1-75.9;范围62 - 79)。差异有统计学意义(8.4±5.3;95% ci 5.9-39.7;P = 0.0000)。加载1年后,对23个种植体进行SGRI评分。总体而言,平均SGRI值为2.29±2.41 mm (95% CI 1.22-2.98 mm)。种植体放置时骨体积为2.41±0.25 CC (95% CI 2.22-2.48 CC)。在6个月的浸没愈合期间,观察到骨轻微收缩11.3%。(2.13±0.24 cc;95% ci 2.02-2.26;差值= 0.27±0.25 CC;95% ci 0.10-0.36;P = 0.0011)。在加载后的第一年,骨移植保持稳定(2.11±0.22 CC;95% ci 2.02-2.24)。差异无统计学意义(0.02±0.07 CC;95% ci 0.01-0.04;P = 0.2166)。从患者角度来看,平均疼痛值为0.52±0.74(范围0-3);平均肿胀值为0.27±0.52(范围0-2);术后3 d镇痛药平均用量为0.87±4.94片(范围0 ~ 4)。形态学和组织形态学分析显示,愈合后6个月,所有样本结构正常,无炎症浸润。骨(未成熟骨+成熟骨):44.07±4.91;残留生物材料:23.98±2.64;髓腔:31.95±3.16。结论:窦底增强可以通过使用专用种植体系统的经瓣入路成功完成。在愈合的前6个月,植骨体的生理性收缩为原始体积的11.3%;之后,没有观察到移植物体积进一步缩小。需要长期的临床研究来证实这些初步结果。
Crestal sinus lift using an implant with an internal L-shaped channel: 1-year after loading results from a prospective cohort study.
Purpose: To evaluate the clinical and radiographic outcomes of a one-stage crestal sinus elevation procedure using a self-tapping endosseous implant system (iRaise, Maxillent, Herzliya, Israel) developed for sinus augmentation, 1 year after loading.
Materials and methods: Patients needing restoration in the posterior maxilla with a residual alveolar crest of 3 to 8 mm in height and 5 mm in width distal to the canine as measured on CBCT scan were treated using the iRaise sinus lift system. Outcome measures were: implant and prosthetic failures, any complications, increased bone height (iBH), marginal bone loss (MBL), implant stability quotient (ISQ), radiographic tissue remodelling patterns using the sinus grafting remodelling index (SGRI), volumetric measurements of sinus graft, patient self-reported post-surgical swelling, consumption of pain medication and histological analysis.
Results: A total of 30 consecutive participants with a mean age of 54.2 ± 9.4 years underwent a transcrestal elevation of the sinus membrane, insertion of bone graft, and implant placement. A total of 50 implants were placed (30 iRaise system implants and 20 adjunctive iSure implants, Maxillent). The mean follow-up was 15.8 ± 2.1 months after implant loading. One patient dropped out at the 1-year after loading follow-up examination. No implants and no prostheses failed during the entire follow-up. One patient experienced a small membrane tear. Before implant insertion, the mean residual alveolar ridge height was 4.64 ± 0.86 mm (range: 3.4-6.4 mm; 95% CI: 4.39-5.01 mm). One year after loading, the bone height was 16.86 ± 3.13 mm (95% CI 15.83-18.07 mm). At the 1-year after loading follow-up, the mean MBL was 0.19 ± 1.05 mm (95% CI 0.02-0.78 mm). The mean ISQ at implant placement was 65.2 ± 5.4 (95% CI 63.6-67.4) and increased during the healing period reaching the mean value of 73.6 ± 3.7 (95% CI 73.1-75.9; range 62-79). The difference was statistically significant (8.4 ± 5.3; 95% CI 5.9-39.7; P = 0.0000). One year after loading, SGRI score was evaluated in 23 implants. Overall, the mean SGRI value was 2.29 ± 2.41 mm (95% CI 1.22-2.98 mm). Bone volume at implant placement was 2.41 ± 0.25 CC (95% CI 2.22-2.48 CC). During the 6-month, submerged healing period, a slight bone contraction of 11.3% were observed. (2.13 ± 0.24 CC;95% CI 2.02-2.26; difference = 0.27 ± 0.25 CC; 95% CI 0.10-0.36; P = 0.0011). At the first year post-loading period, the bone graft remained stable (2.11 ± 0.22 CC; 95% CI 2.02-2.24). The difference was not statistically significant (0.02 ± 0.07 CC; 95% CI 0.01-0.04; P = 0.2166). From the patient's point of view, the mean pain value was 0.52 ± 0.74 (range 0-3); mean swelling value was 0.27 ± 0.52 (range 0-2); and the mean consumption of analgesic was 0.87 ± 4.94 tablets (range 0-4) 3 days after surgery. Morphological and histomorphometric analyses showed that all the samples had a normal structure without inflammatory infiltrate, six months after healing. The following fractions (%) were found: bone (immature bone + mature bone): 44.07 ± 4.91; residual biomaterial: 23.98 ± 2.64; medullary spaces: 31.95 ± 3.16.
Conclusions: Sinus floor augmentation can be successfully accomplished with a transcrestal approach using a dedicated implant system. A physiologic contraction of 11.3% of the original volume of the bone graft was experienced during the first 6 months of healing; afterwards, no additional graft volume reduction was observed. Long-term clinical studies are needed to confirm these preliminary results.