Sinusliftbehandeling is effectief en voorspelbaar

NTVT, 3 december 2010


In een retrospectief onderzoek werd de uitkomst van 177 sinusliftbehandelingen ten behoeve van implanteren, uitgevoerd tussen 1996-2007, nader onderzocht. De onderzochte groep bestond uit patiënten met ernstige atrofie van de bovenkaak die waren behandeld met geosseo-integreerde implantaten, geplaatst in kunstmatige verhoogde sinussen. Rookgedrag, comorbiditeit, voorkomen van orale tumoren in het verleden en aspecten van de chirurgische behandeling werden geanalyseerd.

Bij 119 patiënten werden 177 sinusliften uitgevoerd. Van de 272 geplaatste implantaten in deze regio gingen 19 implantaten verloren. Na 5 jaar was het totale overlevingspercentage 93. Complicaties zoals perforatie van een membraan , sinusitis en peri-implantitis bleken voorspellende factoren bij het falen van implantaten.
Geconcludeerd wordt dat een sinusliftbehandeling effectief en voorspelbaar is. De overleving van de implantaten in deze regio blijkt hoog en onafhankelijk van het gebruikte graftmateriaal, de chirurgische techniek, comorbiditeit, rookgedrag en het moment van plaatsing van het implantaat.

Abstract
Purpose: This retrospective study sought to demonstrate the outcome of maxillary sinus elevation surgery in a series of 177 procedures performed over 12 years and to determine the existence of variables that could independently predict implant survival.
Materials and Methods: A retrospective descriptive and analytic study of a series of maxillary sinus elevation procedures performed between 1996 and 2007 was undertaken. The sample was composed of patients with severe atrophy of the posterior maxilla who had been rehabilitated with osseointegrated implants placed in grafted maxillary sinuses. Several features of the patients (smoking habit, presence of comorbidities, and previous oral carcinoma) and of the surgical procedure (grafting material, associated procedures, associated materials, simultaneous/delayed implant placement, and complications) related to implant survival or failure were monitored during the follow-up period. Implant survival and the existence of variables that could predict implant survival independently were analyzed statistically.
Results: 177 sinus augmentation procedures were performed in 119 consecutive patients (mean age 50.02 years; SD 11.5). Of the 272 implants placed in sinus-augmented regions, 19 were lost. The mean follow-up period was 60.7 months (SD 36.5). The overall cumulative implant survival rate was 93% after 5 years. The multivariate analysis showed that the presence of complications related to the sinus augmentation procedure (membrane perforation and sinusitis) and peri-implantitis were factors in predicting implant failure.
Conclusions: On the basis of this retrospective analysis, it might be concluded that sinus augmentation is a very versatile procedure. Its efficacy and predictability in terms of implant survival rate is extremely high and independent of the graft material, surgical technique, associated comorbidities, smoking habits, and timing of implant placement. Complications such as membrane perforation, sinusitis, and peri-implantitis appeared to influence implant failure.

Bron
• Cho-Lee GY, Naval-Gías L, Castrejón-Castrejón S, et al. A 12-year retrospective rnalytic study of the implant survival rate in 177 consecutive maxillary sinus augmentation procedures. Int J Oral Maxillofac Implants 2010; 25: 1019-1027.

Sinusliftbehandeling is effectief en voorspelbaar

 

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