Osteotome sinus floor elevation with or without grafting: a 3‐year randomized controlled clinical trial

Abstract

Aims: To evaluate the clinical and radiographic results of dental implant placed using osteotome sinus floor elevation (OSFE) with and without simultaneous grafting. Materials & Methods: Forty-five patients were randomly assigned into two groups: Group1: OSFE with deproteinized bovine bone mineral (DBBM) mixed with autogenous bone chips, and Group2: OSFE without grafting. The endosinus bone gain (ESBG) was assessed on radiographs at 6, 12, 24, 36 months following surgery as primary outcome measurement. Implant survivals and marginal bone loss (MBL) were assessed as secondary outcome measurements. Results: Twenty-one implants in Group1 and 20 implants in Group2 were analysed. The residual bone height (RBH) was 4.63 AE 1.31 mm in average (4.67 AE 1.18 mm for Group1 and 4.58 AE 1.47 mm for Group2). The 3-year cumulative survival rates of implants were 95.2% for Group1 and 95.0% for Group2. The ESBG in Group1 reduced from 5.66 AE 0.99 mm at 6 months to 3.17 AE 1.95 mm at 36 months, whereas the ESBG in Group2 increased from 2.06 AE 1.01 mm at 6 months to 3.07 AE 1.68 mm at 36 months. The MBL after 3 years was 1.33 AE 0.46 mm in Group1 and 1.38 AE 0.23 mm in Group2. Conclusions: OSFE and simultaneous implant installation with and without grafting both resulted in predictable results. The application of grafting materials has no significant advantage in terms of clinical success. The posterior maxilla is often difficult for implant placement due to the poor bone quality and insufficient bone volume. Maxillary sinus floor elevation is one of the solutions to solve this problem.There are two major approaches to enter sinus cavity and elevate sinus membrane: the lateral approach and transalveolar technique. The transalveolar sinus floor elevation or osteotome sinus floor elevation (OSFE) was first introduced by Tatum (1986) and modified by Summers (1994) later. The literature mainly reported predictable results of implants placed with OSFE (Tan et al. 2008), which is considered much less invasive and traumatic than the lateral approach.However, there is still controversy regarding the necessity of simultaneous grafting materials in OSFE procedure. Autogenous, allogenic or xenogenic grafting materials are often filled into the elevated area to maintain the space for new bone formation

Outcomes of maxillary sinus floor augmentation without grafts in atrophic maxilla: A systematic review and meta‐analysis based on randomised controlled trials

“…Three of the included trials reported on the endosinus bone gain . The test for heterogeneity showed no significant heterogeneity ( P = 0.40, I 2 = 0%).…”

Crestal Approach to Sinus Floor Elevation for Atrophic Maxilla Using Platelet-Rich Fibrin as the Only Grafting Material

“…1,6 Two recent prospective randomized studies 7,8 have shown that grafted sinus floor elevation promotes more bone gain and better implantation than graft-free sinus floor elevation. However, there were no differences in clinical outcomes such as survival rates.…”

Resonance Frequency Analysis of Sinus Augmentation by Osteotome Sinus Floor Elevation and Lateral Window Technique

“…11 In fact, the application of grafting material might provide no major advantage in clinical success. 12 Furthermore, the less invasive nature of OSFE has been found to provide increased case acceptance with decreased treatment time and expense. 13 Given the different possible sinus lift complications-including, but not limited to, perforation of the sinus membrane, obliteration of the sinus cavity, hemo-sinus, and sinusitis 14 -it is certainly desirable to develop suitable criteria for case selection.…”