Predictability of Simultaneous Implant Placement in the Severely Atrophic Posterior Maxilla: A 9-Year Longitudinal Experience Study of 2,132 Implants Placed into 731 Human Sinus Grafts

Purpose: One-stage implant placement in the grafted maxillary sinus has traditionally been limited to patients with at least 5 mm of residual bone to ensure complete implant stabilization. The aim of this prospective study was to determine the long-term survival rates of implants with roughened surfaces placed immediately into maxillary sinus grafts in patients with 1 to 5 mm of residual bone. Materials and Methods: A total of 2,132 microtextured screw-type (n = 1,374) or hydroxyapatite-coated cylinder-type (n = 758) implants were immediately placed into the grafted sinuses of 731 patients. The implants were restored and monitored for up to 9 years of clinical follow-up. Results: Cumulative survival at 9 years was 97.9% (n = 2,091 implants); 20.4% of the implants were placed in 1 to 2 mm of residual bone. Discussion: Initial implant stability and parallelism were achieved through a combination of meticulous condensation of the particulate bone graft material around the implants, the frictional interface of the roughened implant surfaces and the host tissues, and selection of an appropriate graft material. Conclusions: Simultaneous implant placement into sinus floor grafts can be a predictable treatment option for patients with at least 1 to 2 mm of vertical residual bone height when careful case planning and meticulous surgical techniques are used. (More than 50 references) Keywords: bone graft, implants, sinus lift, subantral augmentation