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31 July 2020

TSFE without graft does not present higher risk of implant failure, JCP Digest

Categories:Clinical Practice, Communication



Implant placement done by transcrestal sinus-floor elevation (TSFE) without graft does not present a higher risk of failure compared to implant placement in native bone in the maxilla, according to research summarised in the latest issue of JCP Digest.

Researchers at the University of Heidelberg in Germany evaluated the effects of both TSFE and bone height on long-term implant survival.

Summarised as JCP Digest issue number 77, this retrospective observational cohort addressed the fact that placing dental implants in the posterior maxilla often requires sinus-floor elevation because of insufficient bone height.

Augmentation can be performed using either lateral-window elevation or TSFE, where draft material is placed below the Schneiderian membrane. An advantage of TSFE is that it is a less invasive approach with less post-operative morbidity. But limitations of sinus-floor augmentation with bone-graft materials have been reported, so some clinicians have opted to prefer using only blood clots.

This study showed that TSFE without graft in bone heights of more than 6mm has an “outstanding” 97.6% 10-year probability of implant survival and a lower – “yet still encouraging” – probability of 95.7% in bone heights of 4-6mm. But in severely reduced sites (1-3 mm), the survival rate was only 77.4%.

The research was summarised for JCP Digest by students of the EFP-accredited postgraduate programme in periodontology and implant dentistry at the University of Hong Kong.