Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients Michael M. Bornstein Vivianne Chappuis Thomas von Arx Daniel Buser Authors’ affiliations: Michael M. Bornstein, Vivianne Chappuis, Thomas von Arx, Daniel Buser, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland Correspondence to: Prof. Dr. Daniel Buser Department of Oral Surgery and Stomatology School of Dental Medicine University of Bern Freiburgstrasse 7 CH-3010 Bern Switzerland Tel.: þ 41 31 632 25 55 fax: þ 41 31 632 98 84 e-mail: daniel.buser@zmk.unibe.ch Key words: clinical trial, dental implants, posterior maxilla, sinus floor elevation, staged procedure Abstract Objectives: The aim of this prospective study was to evaluate the 5-year performance and success rate of titanium screw-type implants with the titanium plasma spray (TPS) or the sand-blasted, large grit, acid-etched (SLA) surface inserted in a two-stage sinus floor elevation (SFE) procedure in the posterior maxilla. Material and methods: A total of 59 delayed SFEs were performed in 56 patients between January 1997 and December 2001, using a composite graft with autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) or synthetic porous b-tricalcium phosphate (b-TCP). After a healing period averaging 7.75 months, 111 dental implants were inserted. After an additional 8–14-week healing period, all implants were functionally loaded with cemented crowns or fixed partial dentures. The patients were recalled at 12 and 60 months for clinical and radiographic examination. Results: One patient developed an acute infection in the right maxillary sinus after SFE and did not undergo implant therapy. Two of the 111 inserted implants had to be removed because of a developing atypical facial pain, and 11 implants were lost to follow-up and were considered drop-outs. The remaining 98 implants showed favorable clinical and radiographic findings at the 5-year examination. The peri-implant soft tissues were stable over time; the mean probing depths and mean attachment levels did not change during the follow-up period. The measurement of the bone crest levels (DIB values) indicated stability as well. Based on strict success criteria, all 98 implants were considered successfully integrated, resulting in a 5-year success rate of 98% (for TPS implants 89%, for SLA implants 100%). Conclusion: This prospective study assessing the performance of dental implants inserted after SFE demonstrated that titanium implants can achieve and maintain successful tissue integration with high predictability for at least 5 years of follow-up in carefully selected patients. In the posterior maxilla, reduced bone height and low bone density are the most common limitations for the placement of endosseous dental implants. To overcome these anatomical obstacles, various ap- proaches such as tilted implants (Aparicio et al. 2001), short implants (Toffler 2006) or grafting of the maxillary sinus floor (ten Bruggenkate & van den Bergh 1998; Tiwana et al. 2006) have been described in the literature. Grafting the maxillary sinus floor has become well accepted and is the surgical procedure most commonly used to increase insufficient bone volume in the posterior maxilla (Strietzel 2004). The technique of sinus floor elevation (SFE) was first published in 1980 (Boyne & James 1980). Boyne and James used Date: Accepted 12 December 2007 To cite this article: Bornstein MM, Chappuis V, von Arx T, Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients. Clin. Oral Impl. Res. 19, 2008; 1034–1043 doi: 10.1111/j.1600-0501.2008.01573.x 1034 c  2008 The Authors. Journal compilation c  2008 Blackwell Munksgaard