Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area: A randomized controlled trial clinical study with one-year follow-up.

BACKGROUND: In previous studies, immediate implant placement in molar sites has been widely applied. PURPOSE: To study the clinical effect and feasibility of immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area. MATERIAL AND METHODS: Patients who required implantation surgry to replace a failing tooth in the maxilla molar region were selected. Patients were randomized into two groups: immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing (test group) or delayed implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing (control group). The outcome criteria were the success rates of implants, Cone Beam Computer Tomography (CBCT) data and results of the subjective satisfaction survey performed with a visual analog scale (VAS). RESULTS: All implants had good initial stability after implantation. The survival rate of implants was 100% at 1-year follow-up. At the time of permanent restoration, the differences in average horizontal shrinkage of alveolar bone (W1) on the buccal side between the test group (0.65 +/- 0.12 mm) and the control group (1.23 +/- 0.32 mm) were statistically significant (P < .0001); however, no statistically significant difference (P = .515) was observed on the palatal side (0.3 +/- 0.10 mm vs 0.28 +/- 0.08 mm). The difference in vertical resorption of alveolar bone (H1) on the buccal side between the test group (0.60 +/- 0.18 mm) and the control group (1.53 +/- 0.19 mm) was statistically significant (P < .0001), but no statistically significant difference (P = .190) in the reduction of palatal alveolar bone (0.24 +/- 0.12 mm vs 0.29 +/- 0.13 mm) was observed. After 1-year loading, no statistically significant difference (P > .05) in vertical or horizontal changes (W2, H2) were identified in the test group or control group. Patient satisfaction in both groups was similar (8.36 +/- 1.01 vs 8.14 +/- 1.35), and the difference between groups was not statistically significant (P = .638). CONCLUSION: Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing is feasible for the maxillary molar area, and the clinical effect is satisfactory.