ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Sinus Augmentation Versus Short Implants
Clinical Question In patients with insufficient bone volume in the posterior maxillae, does sinus augmentation improve dental implant rehabilitation better than those that receive a shorter implant?
Clinical Bottom Line Both procedures appear to have successful outcomes but there is no strong evidence that makes either superior to the other, nor are there directly comparative studies available to clarify this issue. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20238367Esposito/2010250 patients with insufficient bone in posterior maxillaeSystematic Review
Key resultsOne trial suggests 5 mm implants with a diameter of 6 mm can be successfully loaded 4 months after placement without augmentation. These findings were labeled as inconclusive due to the small sample size and short follow up. Nine trials were testing the efficiency of different augmentation procedures. Bone substitutes such as Bio-Oss and Cerasorb could be used as a replacement for autogenous bone grafting, but there was no evidence that addition of PRP treatment to autogenous bone grafts or substitutes improves the outcome of sinus lift procedures.
Evidence Search #Limits: Meta-Analysis Search "Maxillary Sinus"[Mesh] Search "Dental Implants"[Mesh]
Comments on
The Evidence
This article is a systematic review of randomized controlled trials and has comprehensive, detailed search for relevant trials. The individual studies were assessed for validity with 10 trials and 250 patients. There was a meta-analysis done for only 3 trials. The major limitation with this review is that there are few studies directly asking this comparative question. As a result, it remains to be determined if short implants can be used successfully in the posterior maxilla.
Applicability Both procedures appear to have successful outcomes but there is no strong evidence that makes either superior. Treating patients with short implants with comparable levels of success to sinus grafting have the potential to save patients from undergoing sinus grafting procedures.
Specialty/Discipline (General Dentistry) (Periodontics) (Prosthodontics)
Keywords Sinus augmentation, implants
ID# 792
Date of submission: 03/18/2011spacer
E-mail woodye@livemail.uthscsa.edu
Author Elise Woody
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Thomas Oates, DMD, PhD
Faculty mentor/Co-author e-mail OATES@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Erin Wyrick, Jeremiah Whetman (San Antonio, TX) on 08/08/2013
We conducted a PubMed search on this topic in August 2013 and found additional information had been published since the CAT. A systematic review (Atieh / 2012 PMID: 23189281 ) and a literature review (Deporter/2013 PMID: 23820705 ) claimed similar survival rates of short dental implants to long dental implants regardless of surface texture, design, or width. We also found two publications regarding preliminary results from two randomized control trials comparing the placement of short implants vs. long implants/augmented bone in a split-mouth design (Esposito / 2012 PMID: 22518377) and a parallel group design (Felice / 2012 PMID: 22866291 ). All studies confirmed the conclusions of the CAT in regards to both treatment options having successful outcomes and the insufficiency of evidence regarding long-term treatment outcomes/superiority recommendations.
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