Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Dec 2018

Association of Smoking Habits and Height of Residual Bone on Implant Survival and Success Rate in Lateral Sinus Lift: A Retrospective Study

DDS,
DDS,
DDS,
DDS,
DDS, and
MD, DDS
Page Range: 432 – 438
DOI: 10.1563/aaid-joi-D-17-00192
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The primary aim was to evaluate the association of patient-related factors, biomaterials, and implant characteristics on complications' rate of sinus graft surgery and on implant survival rate in grafted sinus. Secondary aims were to measure bone remodeling around implants and patient satisfaction. A retrospective cohort study was designed. Patients who had computerized tomography (CT) before sinus surgery (T0), orthopantomography after implant surgery (T1) and at follow-up (T2), were included. Specific forms were used to collect clinical data. Radiographic measures were: height of residual bone before sinus surgery measured on CT (T0) and apical and marginal bone levels around implants measured on orthopantomography at T1 and T2. Forty-three lateral sinus lifts were performed. Three grafts failed before implant insertion. Out of 83 implants inserted in 29 patients, a total of 19 failed. Mean follow-up (T2) was 6 ± 1.8 years [4; 11.2 years]. The multilevel models analysis showed no association between complications rate and patient-related factors, biomaterials, and implant characteristics. Smoking (odds ratio [OR]: 8.3; 95% CI 1.46–48.05, P = .0173) and height of residual bone (OR: 0.32 for each mm; 95% CI 0.15–0.68, P = .0034) were associated with implant failure. Bone remodeling between T1 and T2 was −0.8 ± 0.2 mm for apical bone and −0.6 ± 0.3 mm for marginal bone. General therapy satisfaction measured in a visual analogue scale was 8.4 ±1.4. In conclusion, lower height of residual bone before sinus surgery and smoking habits had a negative prognostic effect on survival rate of dental implants placed in grafted sinuses.

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  <sc>Figure 1</sc>
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Figure 1

Example of radiographic measures at T0 on cone-beam computerized tomography. Light green: height of residual bone before sinus surgery (HRB).


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  <sc>Figure 2</sc>
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Figure 2

Example of radiographic measures at T1 and T2 on orthopantomography. Green: radiographic implant length (RIL) and diameter. Light blue: height of residual bone at the mesial (mHRB) and distal (dHRB) aspects of the implant. Yellow: height of the graft apically (aGH). Orange: implant penetration (IP). Red: extent of the sinus lift (SL). Light yellow: marginal bone level at the mesial (mMBL) and distal (dMBL) aspects of the implant. Dark blue: vertical bone height at the mesial (mVBH) and the distal (dVBH) aspects of the implants. Purple: crown-to-implant ratio (C/I).


Contributor Notes

Corresponding author, e-mail: luigi.barbato@unifi.it
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