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.