Indirect Sinus Floor Elevation for Osseointegrated Prostheses. A 10-Year Prospective Study

The aim of this study was to evaluate the indirect/closed maxillary floor elevation technique for the insertion of osseointegrated implants to support fixed prostheses clinically. Thirty-one patients (19 female, 12 male) with a mean age of 62 +/- 9 years were selected for this study. All patients needed implants in the posterior maxillary region to support osseointegrated prosthesis. Forty-seven implants were inserted using the indirect/closed sinus floor elevation method, and another 31 implants were placed in the same individuals as intra-individual control. No augmentation material was used along with implantation. The mean bone height before sinus lift was 9.78 +/- 1.68 mm (minimum 5.6 mm), and for controls it was 15.62 +/- 3.44 mm. The average length of the implants used was 12.00 +/- 1.70 mm, whereas for controls it was 13.39 +/- 1.60 mm. The patients were recalled for periodic checkups every 6 months, and the radiographic controls were made every 12 months. One control fixture failed after uncovering; 77 implants were loaded, and 5 of them failed (2 controls and 3 of the sinus lift group) between 3 and 59 months following loading. One hundred nineteen months after surgery (112 months following loading), the censored survival rate (Kaplan-Meier) was 93.6% for sinus lift implants and 90.3% for controls. The crestal bone level changes were not significant either before loading or after loading for both sinus lift and control implants. None of the remaining implants showed any signs of mobility or peri-implant disease, and none of the patients exhibited sinus problems during the entire observation period.