Long-term outcomes of osteotome sinus floor elevation without grafting in severely atrophic maxilla: A 10-year prospective study

Objective The aim of the present study was to report 10-year results of osteotome sinus floor elevation (OSFE) without grafting severely atrophic maxilla (residual bone height <= 4 mm). Materials and Methods Patients undergoing OSFE without grafting and implant placement were included for 10-year examinations. Implant survival, complication-free survival, modified bleeding index (mBI), modified plaque index (mPI), pocket probing depth (PPD), peri-implant marginal bone loss (MBL), endo-sinus bone gain (ESBG) and mean cost of recurrence were evaluated. Results Overall, 23 patients with 35 implants attended 10-year examination. Cemented implant crowns or implant-supported fixed dental prostheses were delivered to the patients. Kaplan-Meier implant survival was 89.2% at implant level and 84.1% at patient level. Complication-free survival was 26.0% at patient level and 37.0% at implant level. The average complication-free survival time was 74.6 months (95% CI: 63.2-86.0 months) at implant level and 69.1 months (95% CI: 54.8-83.4 months) at patient level. The mBI, mPI, PPD, MBL and ESBG at 10-year follow-up were 0.91 +/- 0.58, 0.48 +/- 0.51, 2.94 +/- 0.79 mm, 1.63 +/- 0.83 mm and 2.72 +/- 0.51 mm, respectively. The cost of managing recurrence was 43.6% of the initial cost of treatment. Conclusion The results of the present study indicate that OSFE without grafting is a reliable treatment option in severely atrophic maxilla. Acceptable survival rate, stable MBL and ESBG could be achieved within 10 years. Low complication-free survival and high costs of recurrence management need to be considered.