Morbidity following transcrestal and lateral sinus floor elevation: A randomized trial

Abstract

AimTo comparatively evaluate the morbidity following maxillary sinus floor elevation according to either transcrestal (tSFE) or lateral (lSFE) approach with concomitant implant placement.Materials & MethodsPatients with ≥1 edentulous maxillary posterior site with residual bone height (RBH) of 3–6 mm were enrolled. tSFE was performed in association with a xenograft and a collagen matrix. For lSFE, the sinus was grafted with the xenograft, and the antrostomy was covered with a membrane. Implants were inserted concomitantly. The postoperative course was assessed through questionnaires. Pain level (VAS pain) was recorded using a 100‐mm visual analogue scale.ResultsTwenty‐nine and 28 patients were included in tSFE and lSFE group, respectively. On the day of surgery, VAS pain was significantly higher for tSFE compared to lSFE, and similar from day 1 to 14. tSFE was characterized by significantly lower incidence of swelling, bruising and nasal discharge/bleeding. Significantly less severe limitation in swallowing, continuing daily activities, eating, speaking, opening the mouth and going to school/work was found for tSFE only at specific postsurgery intervals.Conclusions lSFE was associated with lower pain on the day of surgery, and tSFE revealed lower postoperative morbidity as well as more tolerable postoperative course.

Radiographic outcomes of transcrestal and lateral sinus floor elevation: One‐year results of a bi‐center, parallel‐arm randomized trial

“…In the present material, aGH was significantly higher in lSFE group than in tSFE group (6.5 mm vs. 0.9 mm, respectively). This finding is consistent with previous studies indicating that substantially greater volumes of grafted space can be obtained with lSFE (2.84 cm 3 ) compared with tSFE (0.63 cm 3 ) (Temmerman et al, ) and reflects the different surgical approach and average amount of DBBM (lSFE: 1,975 mg; tSFE: 420 mg) used in the two interventions (Farina et al, ). Interestingly, at 12 months post‐surgery aGH was 0 in 13% of patients of the tSFE group.…”

“…The study is a bi‐center, parallel‐arm, single‐blind, randomized controlled clinical trial and is part of a larger project which comparatively evaluated tSFE and lSFE under several perspectives. Information on ethical approval and trial registration, the methodological aspects of the study, and the surgical aspects of the procedures have been reported in a recent publication on the morbidity of tSFE and lSFE (Farina et al, ). The present study reports only methodological aspects and data function to evaluate the radiographic outcomes of the two investigated interventions.…”

“…Measurements on digitized periapical radiographs were performed using a image-processing software (NIS Elements ® v4.2; Nikon Instruments), while a software for implant planning was used for measurements on CT and CBCT scans (Nobel clinician © v2.6.3.2; Nobel Biocare Services AG). All radiographic measurements were performed by a single trained examiner (G.F.) who had previously undergone a calibration session for linear measurements on periapical radiographs on a sample of 15 patients not included in the study (Cohen's k-coefficient for intra-examiner agreement: 0.981) and had participated as clinical examiner in previous clinical trials on sinus lift procedures (Farina et al, 2018;Franceschetti, Farina, Minenna, Franceschetti, & Trombelli, 2015;Franceschetti et al, 2014Franceschetti et al, , 2017Trombelli et al, 2012Trombelli et al, , 2014Trombelli et al, , 2008Trombelli, Franceschetti, Trisi, & Farina, 2015;Trombelli, Minenna, Franceschetti, Minenna, Itro, et al, 2010). The examiner was kept blinded as to treatment group and observation interval.…”

The impact of graft remodeling on peri‐implant bone support at implants placed concomitantly with transcrestal sinus floor elevation: A multicenter, retrospective case series

“…The study protocol was approved by the Local Ethical Committee of Ferrara, Italy (protocol number: 170194). Surgical procedures were performed at the Research Centre for the Study of Periodontal and Peri‐implant Diseases, University of Ferrara, Italy, and 3 private dental offices involved in previous clinical trials on the tSFE procedure used in this study (Farina et al, , ; Franceschetti, Farina, Minenna, Franceschetti, & Trombelli, ; Franceschetti et al, , ; Trombelli et al, , , ; Trombelli, Minenna, Franceschetti, Minenna, & Farina, ).…”

The effect of transcrestal sinus‐floor elevation without graft on the long‐term prognosis of maxillary implants

“…In an early review, Tan, Lang, Zwahlen, and Pjetursson (2008) estimated a 3‐year probability of survival of 92.8% for implants placed in combination with TSFE. A randomized clinical trial comparing the intra‐ and post‐surgery morbidity of the transcrestal and lateral sinus‐lift techniques showed lower post‐operative morbidity and a more tolerable post‐operative course for the transcrestal method (Farina et al, 2018).…”