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Objectives: The aim of this prospective clinical trial was to evaluate the success implant rates during 24 months using OSFE procedure without grafting materials. Study design: 42 adult patients (22 female, 15 male) were selected according to Nedir et al´s inclusion criteria of which 5 patients were excluded, due to periapical pathology in adjacent teeth (n=3) and treatment with bisphosphonates (n=2). 37 patients aged 31-68 years were selected. Smokers were divided in two groups depending on the number of cigarettes consumed per day (a) 0-10, (b) 11-20. One patient was excluded because he was lost to follow-up at 24 months A total of 36 threaded implants were placed, ∅4,1mm Straumann® (Straumann AG, Waldenburg, Switzerland) and ∅3,5mm Klockner® (Klockner Implant System, Barcelona, Spain). The most used implant diameter was 4,1 mm (n=29), followed by 3,5 mm (n=7), and length used was 10 mm (n=32) and 8 mm (n=4). Initial RBH ranged from 4 mm to 9 mm. All statistical data were processed using the program R 3.0.2 for windows. Results: A total of 36 threaded implants were placed. Residual bone height (RBH) at implant placement averaged 7,4 ± 0,4 mm. Mean bone gain was 1,8 ± 0,3 mm. Four implants showed a bone gain exceeding 3 mm. Mean implant protrusion length into the sinus amounted to 2.1 ± 0,3 mm. Regarding the relationship between smoking and periodontal probes, no statistically significant differences were found (P=0,25), neither in relation to the number of threads that the implants showed (P=0,29) or bone gain (P=0,79). After 24 months the implant success rate was 91,6%. Conclusions: Implant rehabilitation of edentulous atrophied posterior maxilla can be safely performed and simplified using the OSFE technique without grafting with reliable long-term results. Key words:Crestal bone loss, dental implants, internal sinus lift, no grafting, osteotome sinus elevation, grafting, sinus floor elevation.

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Background: the prognosis of peri-implant surgery can be affected by poor decontamination of the implant surface, which could be improved with the use of titanium brushes. The objectives of this systematic review were to evaluate the effectiveness of titanium brushes in the decontamination of the implant surface in terms of plaque index, probing depth, bleeding on probing and bone loss/gain; as well as its effectiveness according to the type of peri-implant bone defect. Methods: an electronic search was carried out in the PubMed, Scopus, Cochrane and Embase databases, as well as a manual search. The search strategy included four keywords: “Peri-implantitis”, “Periimplantitis”, “Implant Surface Decontamination” and “Titanium Brush”. Randomized controlled studies published in the last 10 years were included and systematic reviews, in vitro studies and animal studies were excluded. Results: 142 references were found, from which only four articles met the inclusion criteria. All of the studies included in the present review reported beneficial results in terms of probing depth, gingival index and radiographic bone loss and gain after implant surface decontamination adjuvated by titanium brushes. Conclusions: titanium rotary brushes show improvements in the evolution and prognosis of peri-implant surgery, although more long-term studies are needed to draw more solid conclusions.