Related Experiment Video
Updated: Oct 16, 2025

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Implant survival after graftless sinus floor augmentation in highly atrophic maxillae: a randomized controlled trial
Suen A N Lie1,2, Carine A W Leung3, Rick M M A Claessen3
1Department of Cranio-Maxillofacial Surgery, (Head: Prof. Dr. P.A.W.H. Kessler), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands. suen.lie@mumc.nl.
Purpose:
The success rate of dental implants after graftless sinus augmentation versus conventional sinus augmentation surgery in atrophic maxillae in edentulous patients was investigated.
Methods:
This randomized study was performed in ten edentulous patients with marked maxillary atrophy. On the graftless side, the sinus membrane was lifted by a resorbable membrane. The control side was augmented with a mixture of autografts and xenografts. Implant placement followed 6 months postoperatively. Outcomes were implant survival, success of prosthetic rehabilitation and stability of vertical bone gain.
Results:
Ten patients were included. Postoperative radiology showed sufficient bone gain on both maxillary sides. Follow-up varied from 57 to 88 months. The conventional side showed significant (p = 0.041) more bone gain than the experimental side (respectively, 9.69 mm and 6.20 mm). A total of 59 implants were placed: 30 after conventional, 29 after graftless augmentation. One implant was lost on the conventional side and four on the experimental side. The implant survival was significantly higher on the conventional side (96.7% vs. 86.2%, p < 0.001, RR = 4.14). Prosthetic restoration was functionally successful in all cases.
Conclusion:
Bone gain and implant survival were significantly lower in the non-grafted side versus the grafted side. Prosthetic rehabilitation was possible in all ten patients. The non-grafted technique may have some potential for clinical use, although it showed poorer results. Trial registration The Netherlands Trialregister. NTR NL3541 (NTR3696). Registered 20 January 2013, https://www.trialregister.nl/trial/3541 .

