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

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Regenerative Dentistry

Background:

• Maxillary sinus floor elevation is crucial for dental implant placement in atrophic posterior maxilla.
• Both transcrestal (tSFE) and lateral (lSFE) approaches are utilized, each with distinct morbidity profiles.
• Comparative data on postoperative complications and patient-reported outcomes are essential for clinical decision-making.

Purpose of the Study:

• To compare the postoperative morbidity associated with transcrestal sinus floor elevation (tSFE) versus the lateral approach (lSFE).
• To evaluate pain levels, swelling, bruising, and functional limitations following both tSFE and lSFE procedures with concomitant implant placement.

Main Methods:

• A comparative study involving patients with residual bone height (RBH) of 3-6 mm undergoing either tSFE or lSFE.
• Grafting materials included xenografts and collagen matrices (tSFE) or membranes (lSFE).
• Postoperative pain (VAS), swelling, bruising, and functional limitations were assessed via questionnaires.

Main Results:

• While tSFE showed higher initial pain, it demonstrated significantly lower incidence of swelling, bruising, and nasal discharge.
• Patients undergoing tSFE reported less severe limitations in swallowing, daily activities, eating, speaking, and returning to work/school at specific intervals.
• Postoperative morbidity was generally lower for the tSFE group.

Conclusions:

• Transcrestal sinus floor elevation (tSFE) is associated with lower overall postoperative morbidity compared to the lateral approach (lSFE).
• tSFE offers a more tolerable postoperative course for patients, despite potentially higher immediate pain.
• The findings support tSFE as a favorable option for maxillary sinus augmentation with concomitant implant placement when indicated.