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Clinical outcomes of an osteotome technique and simultaneous placement of Neoss implants in the posterior maxilla.

BACKGROUND
Insufficient bone volume often hamper placement of dental implants in the posterior maxilla.


PURPOSE
The aim of the present clinical study was to evaluate retrospectively the clinical outcome of implant placement in the resorbed posterior maxilla using an osteotome technique without adding any grafting material.


MATERIALS AND METHODS
Twenty patients with 5 to 9 mm of residual alveolar bone height in the posterior maxilla received twenty-nine implants (Neoss Ltd., Harrogate, UK) using an osteotomy technique without bone grafts. Intraoral radiographs were taken before and after implant placement, at the time of loading and after 11 to 32 months of loading (mean 16.4 months), to evaluate bone formation below the sinus membrane and marginal bone loss. Implant stability measurements (Osstell(TM) , Gothenburg, Sweden) were performed after implant installation and at abutment connection 5 months later. All implants were installed with the prosthetic platform level with the bone crest.


RESULTS
No implant was lost giving a survival rate of 100% after a mean follow-up time of 16.4 months. The average vertical bone height was 7.2 ± 1.5 mm at placement and 10.0 ± 1.0 mm after 11 to 32 months. The average increase of 2.8 ± 1.1 mm was statistically significant. There was a statistically significant improvement in implant stability from 70.7 ± 9.2 implant stability quotient (ISQ) at placement to 76.7 ± 5.7 ISQ at abutment connection, 5 months later. The mean marginal bone loss amounted to 0.7 ± 0.3 mm after 11 to 32 months of loading.


CONCLUSION
It is concluded that the osteotome technique evaluated resulted in predictable intrasinus bone formation, firm implant stability, and good clinical outcomes as no implants were lost and minimal marginal bone loss was observed.