上顎洞底挙上術の成功およびインプラント残存に影響を与える因子の検討

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  • Predictive factors for surgical success and survival of dental implants placed with maxillary sinus floor elevation
  • ジョウガクドウテイキョジョウジュツ ノ セイコウ オヨビ インプラント ザンソン ニ エイキョウ オ アタエル インシ ノ ケントウ

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The purpose of this retrospective study was to assess the surgical success and survival of implants placed with maxillary sinus floor elevation and to estimate the factors that influenced implant survival. A total of 131 implants were placed in 74 sinuses of 67 patients. Fifteen sinuses (18 implants) were augmented by the transalveolar osteotome technique (OT), 42 sinuses (75 implants) by the one-stage lateral window technique (1-stage LW), and 17 sinuses (38 implants) by the two-stage lateral window technique (2-stage LW). The Kaplan-Meier estimate of the 5-year success/survival rate of all implants was 93.8%. The estimated success/ survival rate was 100% for OT, 98.6% for 1-stage LW, and 81.2% for 2-stage LW. The results of multivariate analysis using a Cox proportional-hazards model revealed that either residual bone height or the presence of perforation of the sinus membrane was a statistically significant independent predictor of success/ survival. In this study, the residual bone height was closely related to the applied surgical technique. Moreover, perforation of the sinus membrane was associated with infection and bone graft loss in the patients treated by the 2-stage LW. The results of this study suggested that OT was a reliable technique if a long implant ( ≥ 12 mm) was placed with sinus floor elevation of up to 5 mm. Our results also suggested that if the LW is performed, simultaneous implant placement would have a favorable outcome if primary implant stability was obtained.

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