الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 213 |  |  |
| | | from | 213 | | |
Abstract
Implant placement into the posterior maxilla often creates a challenge due to deficiency of maxillary alveolar bone, progressive pneumatization of the maxillary sinuses, increased occlusal forces and high frequency of poor bone quality. A variety of surgical techniques have been developed to increase the vertical bone height in the posterior maxilla. The most common intraoperative complication of sinus elevation is tearing of the schneiderian membrane, which could allow for bacterial complication of the graft or dispersion of the graft into the sinus cavity. Crestal approach sinus augmentation procedure was introduced using safe side end cutting drill with vertical stoppers for elevation of the sinus membrane using the sinus crestal approach (SCA) kit. There is still controversy regarding the necessity of simultaneous grafting materials in sinus floor elevation procedure. Short implants with improved implant design and surface properties have been successfully applied as an alternative to sinus floor elevation surgery and have shown good results in posterior maxilla. The primary objective of this study was to evaluate Stability and Osteointegration of short implants versus long ones in poor residual bone height in posterior maxilla with and without sinus elevation. This present study was conducted on 21 patients in need for implant placement for their lost posterior maxillary teeth (premolars and molars) with limited bone height below the floor of the maxillary sinus. They were selected from the Outpatient Clinic of Oral Medicine, Periodontology, Oral Diagnosis, and Radiology department, Faculty of Dentistry, Tanta University. In the present study, group I, 7 patients received short implants without crestal sinus approach technique and without augmentation material. group II, 7 patients received long implants in combination with crestal sinus approach technique without the use of augmentation material. group III, 7 patients received long implants in combination with crestal sinus approach technique with the use of augmentation material (Hypro-Oss®). The patients were evaluated clinically for implant stability using Smartpeg attached to implant and using Osstell Mentor to measure resonance frequency. The result showed no reliable difference observed between all groups at 7 months. Also, regarding the clinical parametric data like pocket depth and keratinized mucosa width no merit difference existed between all groups. The patients were evaluated radiographically for showing marginal bone loss (MBL), endo sinus bone gain and bone density (BD) by CBCT immediately after surgery and at 12 months post operatively. No significant difference in MBL and bone density between all groups. However significant difference in end sinus bone gain was found between group II and III. Based on the limitation of the results of the present study, it was concluded that: - 1) Short implant placement is an effective alternative option to long implant placement with maxillary sinus augmentation taking into consideration the variability between subjects. 2) The usefulness of short implant may be favorable than long implant placement with or without maxillary sinus augmentation that usually associated with increased risk of complication, cost and surgical time. 3) The choice of short implant with difference width to increase surface area contact with bone guaranteed by the approval of FDA. This could explain why dentist should specify the approach, methods, equipment, implant design, selection of suitable procedures and surgical experience. 4) Invoice for short implant success may be relay entirely on selection of cases and patient behavior for supportive maintenance therapy.