Despite the scarce quantity and quality of the literature that prevents sound conclusions on the causal link between bruxism and the periodontal problems assessed in this review, it seems reasonable to suggest that bruxism cannot cause periodontal damage per se. It is also important to emphasize, however, that because of methodologic problems, particularly regarding sleep bruxism assessment, more high-quality studies (e.g., randomized controlled trials) are needed to further clarify this issue.
Objective
Clinical indications for maxillary sinus floor elevation with transcrestal techniques have increased in recent years even in sites with minimal residual bone height (RBH). Nevertheless, limited information is currently available on incidence of intraoperative complications and early implant failure in these cases.
Material and Methods
This retrospective multicenter study was performed on anonymized clinical and radiographic records of patients who underwent transcrestal sinus floor elevation in seven clinical centers. Influence of different factors related to patient, and sinus anatomy and surgical technique on the incidence of intraoperative complications and early implant failure rate after transcrestal sinus lift were investigated.
Results
A total of 430 patients treated with transcrestal sinus floor elevation for single‐implant insertion in sites with RBH ≤5 mm were included in the final analysis. After 1 year of loading, 418 implants of 430 were satisfactorily in function. Early implant failure was recorded in 12 cases (2.8%); results were significantly associated with the presence of large sinus cavities and with the occurrence of membrane perforation.
The following adverse events were recorded: membrane perforation (7.2%), acute sinusitis (0.9%), implant displacement into the sinus cavity (0.7%), oro‐antral fistula (0.2%), and benign paroxysmal positional vertigo (0.5% of osteotome cases). A strong direct correlation between sinus membrane perforation and bucco‐palatal sinus width (p = .000) was demonstrated.
Conclusions
Early implant failure after transcrestal sinus elevation showed significant direct correlation with bucco‐palatal maxillary sinus width and the presence of membrane perforation. Sinus membrane perforation was strongly associated with bucco‐palatal sinus width (extremely low perforation rate in narrow and much higher incidence in wide sinuses).
With an overall success rate of 98.8%, the study hypothesis that greater insertion torque (>10 Ncm) will decrease the success rate and increase palatal OMI failure was rejected.
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