Implant failure and associated risk factors of transcrestal sinus floor elevation: A retrospective study

Objectives: This retrospective study aimed to evaluate early and late implant loss rates after transcrestal sinus floor elevation (TSFE) and to identify the risk factors related to these failures.

Material and methods: All patients treated with TSFE and simultaneous implant placement during October 2015 to March 2019 were evaluated for inclusion. A total of 802 patients with 976 implants met the inclusion criteria. Clinical and radiographic information was collected from medical records and image software. Univariate and multivariate Cox proportional hazards frailty regression models were performed to identify potential risk factors associated with early and late implant loss after TSFE.

Results: The 3-year cumulative implant survival rate was 96.9% (95% CI 95.8%-98.0%). Twelve implants in 12 patients were lost before or at the abutment connection, while 24 implants in 24 patients were lost after functional loading. The Cox frailty regression analyses indicated that two factors were correlated with early implant loss: TSFE with grafting materials, and operators with less clinical experience. As for late implant loss, RBH ≤6 mm, male sex, and certain implant brands were associated with a significantly increased failure rate.

Conclusions: Transcrestal sinus floor elevation with simultaneous implant placement is a predictable treatment option in the atrophic maxilla. The presence of grafting materials and the lack of clinical experience of the surgeon were possibly associated with early implant loss, while low RBH, male sex, and certain implant brands tended to increase late implant loss.