Effect of Different Crestal Sinus Lift Techniques for Implant Placement in the Posterior Maxilla of Deficient Height: A Randomized Clinical Trial

Abstract

This study evaluated dental implant stability, vertical bone gain, bone density, and crestal bone loss using different crestal sinus lift techniques (osteotomy, Densah burs, and piezosurgery). A total of 21 patients were randomly divided into three groups: Group 1: patients were treated using a Densah drill crestal sinus lift, Group 2: patients were treated using a piezoelectric crestal sinus lift and Group 3: patients were treated using an osteotome crestal sinus lift. The patients in all three groups underwent bone grafting and implant placement. An Osstell device was used to determine the implant stability by recording the values of the implant stability quotient (ISQ). CBCT was performed before and 6 months after implant placement for radiographic evaluation and comparison among the groups. All dental implants were completely successful, and statistically significant differences from baseline to 6 months were noted in all groups (p < 0.05). The Densah burs technique resulted in the best implant stability of all groups, while the osteotome technique demonstrated better vertical bone augmentation. However, the values for bone density and crestal bone loss showed no significant difference among all treated groups (p > 0.05). All three techniques were successful for crestal sinus lifts with good clinical outcomes at a 6-month follow-up. The Densah group demonstrated better implant stability, shorter surgery time, and fewer complications; however, the vertical bone gain was greater with the osteotome technique.

Evaluation of crestal sinus floor elevation in cases exhibiting an oblique sinus floor with a residual bone height of 4.0-7.0 mm using densah burs with simultaneous implant placement. A prospective clinical study

“…In our study, 16 cases with an oblique sinus oor with a RBH ranging from 4 to 7 mm were successfully treated with a closed sinus lift approach using densah burs. The use of these burs in crestal sinus lift has become a well-established minimally invasive technique with minimal complications compared to other sinus lifting techniques [13,19,20]. The burs with their unique ute design and counterclockwise rotation allows for autogenous bone compaction laterally along the walls of the osteotomy as well as apically toward the sinus oor.…”

“…Numerous publications have shown that implants penetrating the sinus can have a favorable outcome with the membrane healing and becoming thickened around the implants in most cases [26,27]. In a canine model, several studies assessing sinus health after the placement of dental implants that penetrated the sinus at variable distances ranging from 2 to 8 mm also showed absence of sinus complications and did not prevent successful implant osseointegration [20,28,29]. In our case with the perforation, the implant healed uneventfully with no clinical or radiographic signs of sinus complications at the one year follow up.…”