Inclined implants to bypass maxillary sinus versus vertical implants placed after sinus augmentation in rehabilitation of posterior atrophic maxilla.A two-years prospective randomized clinical study

Purpose: The aim of currents randomized clinical trial was to evaluate clinical outcome of inclined implants to bypass maxillary
sinus versus vertical implants placed after sinus augmentation in rehabilitation of posterior atrophic maxilla.
Materials and Methods: Twelve patients (6 males, 6 females) with atrophied unilateral posterior edentulous maxillary ridges,
at least 4 - 5 mm of bone height present above the maxillary sinus were randomly allocated into 2 groups: 1) control group;
included 6 participants who received vertical implants after sinus augmentation (lateral window technique), 2) study group;
included 6 participants who received inclined implants to bypass maxillary sinus. All patients received 3 unit fixed metal
ceramic screw retained prosthesis 6 months after implant placement. Clinical outcome (pocket depth,implant stability,marginal
bone loss, and implant survival) were measured at base line, 6, 12, 24 months after implant loading. In addition, patient
satisfaction with treatment was measured for both groups after one month.
Results: Probing depth,implant stability increased significantly from baseline to 12 months for both groups. No significant
difference in probing depth,implant stability between 12 and 24 months was noted.Marginal bone loss significantly increased
from6to 24 months. Control group recorded significant higher marginal bone loss than study group at all-time intervals.Study
group demonstrated significant higher probing depth,implant stability and patient satisfaction with treatment than control
group.cumulative survival rate was 95 % and 100 % for control and study groups respectively.
Conclusion: Inclined implants to bypass maxillary sinus is a viable treatment option in rehabilitation of posterior atrophic
maxilla compared to vertical implants placed after sinus augmentation as it was associated with favorable clinical outcomes
after 2 years. However, it was associated with increased probing depth.