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Effect of the implant apical exposure and coverage < or ≥ 2 mm bone graft on transcrestal sinus floor elevation: a 1- to 7-year retrospective cohort study

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Abstract

Objectives

This study aimed to analyze the effect of the apex coverage by the bone graft, including exposure and coverage less than or greater than 2 mm on implant survival rate and peri-implant bone and soft tissue remodeling.

Materials and methods

A total of 264 implants in 180 patients who had undergone transcrestal sinus floor elevation (TSFE) with simultaneous implant placement were included in this retrospective cohort study. Radiographic assessment was used to categorize the implants into three groups based on apical implant bone height (ABH): ≤ 0 mm, < 2 mm, or ≥ 2 mm. The implant survival rate, peri-implant marginal bone loss (MBL) during short-term (1–3 years) and mid- to long-term (4–7 years) follow-up, and clinical parameters were used to evaluate the effect of implant apex coverage after TSFE.

Results

Group 1 had 56 implants (ABH ≤ 0 mm), group 2 had 123 implants (ABH > 0 mm, but < 2 mm), and group 3 had 85 implants (ABH ≥ 2 mm). There was no significant difference in the implant survival rate between groups 2 and 3 compared to group 1 (p = 0.646, p = 0.824, respectively). The MBL during short-term and mid- to long-term follow-up indicated that apex coverage could not be considered a risk factor. Furthermore, apex coverage did not have a significant effect on other clinical parameters.

Conclusions

Despite limitations, our study found that implant apex coverage by the bone graft, including exposure and coverage levels less than or greater than 2 mm, did not significantly affect implant survival, short-term or mid- to long-term MBL, or peri-implant soft tissue outcomes.

Clinical relevance

Based on 1- to 7-year data, the study suggests that implant apical exposure and coverage levels of less than or greater than 2 mm bone graft are both valid options for TSFE cases.

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Data availability

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This work was financially supported by the National Natural Science Foundation of China (No. 81870801) and the Sichuan Science and Technology Program grant (No. 2022YFS0041).

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Authors and Affiliations

  1. State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin South Road, Chengdu, 610041, Sichuan, China

    Jiayu Gao, Xiangqi Zhao, Yi Man & Yili Qu

  2. Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China

    Jiayu Gao & Yi Man

  3. Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China

    Xiangqi Zhao & Yili Qu

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Contributions

Yili Qu and Yi Man conceived the ideas. Jiayu Gao and Xiangqi Zhao collected the data. Jiayu Gao, Xiangqi Zhao, and Yili Qu analyzed the data and conducted the writing. All authors gave final approval and agreed to be accountable for all aspects of the work.

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Correspondence to Yili Qu.

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The authors declare no competing interests.

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This retrospective study involving human participants was performed in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Ethics Committee of Sichuan University (ethics registration number: WCHSIRB-CT-2021–504). Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data and photographs.

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Jiayu Gao and Xiangqi Zhao are joint first authors.

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Gao, J., Zhao, X., Man, Y. et al. Effect of the implant apical exposure and coverage < or ≥ 2 mm bone graft on transcrestal sinus floor elevation: a 1- to 7-year retrospective cohort study. Clin Oral Invest 27, 3611–3626 (2023). https://doi.org/10.1007/s00784-023-04974-8

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