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Journal of Oral Science & Rehabilitation Issue 01/2015

72 Volume 1 | Issue 1/2015 Journal of Oral Science & Rehabilitation and was considered to represent zero height. In orderto determine bone loss, a perpendicular line was traced mesial and distal to the implant from zero height to contact with the bone (Fig. 1). The differencebetweenthevaluerecordedatthetime of implant loading and after one year of loading wasusedtocalculatebonelossmesialanddistalto the implant. The largest value, either mesial or distal,wasusedasthebonelossvalueforthatim- plant(Fig.2).26 Smokingandoralhygienewererecordedatthe time of surgery. A patient who smoked > 1 ciga- rette/day was considered a smoker following the definition by Wallace.27 Bone loss and success wererecordedat12monthsofprostheticloading. S ta tis tic a l analysi s Adescriptive analysiswas performed ofthe study variables,withtheircorrespondingfrequencydis- tributions and measures of central tendency and dispersion. Statistical comparisons between the groupswereconductedusingthechi-squaredtest and Student’s t-test. The SPSS for Windows sta- tistical software package (Version 15.0; SPSS, Chicago,Ill.,U.S.)wasusedthroughout.Statistical significancewasconsideredforp< 0.05. Results Fiftypatientstreatedwith direct sinus lift and im- plants were monitored during the study period. Fourpatientsfailedtoattendscheduledfollow-up visits and were thus excluded. The final sample consisted of 46 patients (16 men and 30 women) withameanageof49(range:29–69years).These patients underwent 58 direct maxillary sinus lift procedures and received atotalof102 implants in the grafted sites: 50 were placed simultaneously withthesinusliftprocedureand52wereplacedsix monthsthereafter.Implantlengthsanddiameters aredetailedinTable2. Sevenimplantsfailed,allpriortoloading,yield- ing an overall implant success rate of 93.1% at 12 monthsofloading.Fiveoftheseimplantshadbeen placed simultaneously and two implants six months afterthe grafting procedure. The survival was 90.0% for implants placed simultaneously and96.2%fordelayedimplants.Overall,themean periimplant marginal bone loss was 0.58  mm (range:0.24–0.95 mm).Implantsplacedsimulta- neouslyhad a mean bone loss of0.62 mm (range: 0.21–0.97 mm) and implants placed in a second procedure of 0.54  mm (range: 0.27–0.93  mm; Table3). With respect to smoking, 69 implants were placed in nonsmokers and 33 in smokers. Non- smokers presented a higher implant success rate at 12 months (94.2%) and lower mean bone loss (0.52 mm; range: 0.21–0.84 mm) than smokers (90.9% and 0.60  mm; range: 0.24–0.92  mm; Table4).However,thesedifferenceswerenotsta- tisticallysignificant. In relation to oral hygiene, 47 of the 102 im- plants were placed in patients with good oral hy- giene,42withregularand13withpoorhygiene.In patientswithpoororalhygiene,thesuccessrateat 12 monthswas lower(81.8%), comparedwith pa- tients with regular (92.3%) or good hygiene (95.5%). Mean bone loss at 12 months was 0.51 mm (range: 0.21–0.82 mm) in patients with good oral hygiene, 0.57  mm (range: 0.24– 0.82 mm) in patients with regular hygiene, and 0.66 mminthosewithpoorhygiene(range:0.32– 0.92 mm;Table5).Theobserveddifferenceswere innocasestatisticallysignificant.Thesurvivalrate of implants placed in patients with poor oral hy- giene was lower than in patients with regular or goodhygiene.Thesedifferenceswereclosetosta- tisticalsignificance(p= 0.058). S uc c es s of im pla n ts place d af te r di re ct si nu s li f t Fig. 1 Fig. 2 Fig. 1 Radiographic assessment of bone level at implant loading. Fig. 2 Radiographic assessment of bone level 12 months after loading.

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