Generally current dental implant placement is a successful procedure with predictable outcomes, especially when sited within normal quality and quantity of bone. The posterior maxilla, however, can be challenging. This is especially so with reduced bone volume following loss of teeth and bone and proximity of the maxillary sinus. A number of innovative solutions are widely practised, including sinus bone grafting. Controversy exists regarding the survival of these implants in augmented sites versus non augmented sites. This retrospective study looks at the predictors for dental implant failure in the posterior maxilla. Over five years 1395 implants were placed in 592 patients. Usual factors were analysed: sinus elevation, implant length, implant diameter, maxillary region, time point of insertion, one or two stage and healing mode. No detectable predictive risk factors were identified. This is a large cohort study and well designed. It has the limitations of being a retrospective study and limitation of the variables studied. It is worth reading to get an overview as this is a difficult restorative option. It does at least give operators figures to quote of success greater than 90% in the grafted maxilla; native bone success is 95%. The paper discusses the usual causes of failures and thus provides insight in treatment planning for restoration.

Analysis on implant-failure predictor in the posterior maxilla: A retrospective study of 1395 implants.
Pabst AM, Walter C, Ehbauer S, et al.
Journal of Cranio-Maxillo-Facial Surgery
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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