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Sinus floor elevation using osteotomes or piezoelectric surgery.

D Baldi¹, M Menini, F Pera

¹Dept. Fixed and Implant Prosthodontics, Genoa University, Italy.

International Journal of Oral and Maxillofacial Surgery

|March 1, 2011

Summary

This study presents a crestal approach for sinus floor augmentation in cases with minimal residual bone, achieving a 97% implant survival rate. Tapered implants showed better bone height gain compared to cylindrical ones.

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Area of Science:

Dentistry
Oral Surgery
Implantology

Background:

Atrophic posterior maxilla often requires bone augmentation for dental implant placement.
Sinus floor augmentation is a common procedure to increase bone height in the posterior maxilla.
Minimally invasive techniques are sought for sinus floor elevation, especially when residual bone is limited (≤ 7.5mm).

Purpose of the Study:

To describe and evaluate a 1-step crestal approach technique for sinus floor augmentation.
To assess the outcomes of immediate dental implant placement following this augmentation technique.
To compare the efficacy of osteotomes/burs versus piezosurgery for sinus floor elevation.

Main Methods:

A prospective study involving 25 patients with atrophic posterior maxilla (residual bone ≤ 7.5mm).

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36 dental implants were placed immediately after sinus floor elevation using a 1-step crestal approach (osteotomes/burs or piezosurgery).

Radiographic evaluation pre-surgery and 1 year post-surgery; implant stability assessed at 12 months.

Main Results:

Mean residual bone height was 5.61mm; mean sinus elevation gain was 6.78mm at 1 year.
Cumulative survival rate of implants was 97% (33 out of 34 implants stable at 12 months).
Tapered implants resulted in statistically significant higher bone height gain compared to cylindrical implants (P<0.05).

Conclusions:

The 1-step crestal approach is a viable technique for sinus floor augmentation in cases with limited residual bone.
Immediate implant placement following this procedure demonstrates high survival rates.
Piezosurgery offers patient comfort and surgeon convenience, though both methods yielded similar bone level results.