A Randomized Comparative Trial of Osseodensification Versus Osteotome Technique for Transcrestal Sinus Elevation with...

To compare the outcomes of osseodensification and osteotomy in transcrestal sinus elevation with simultaneous implant placement in patients with limited maxillary posterior bone height.

This prospective randomized clinical trial included 28 patients with 42 implants, which were divided into two groups: osseodensification (n = 22 implants) and osteotomy (n = 20 implants). The primary outcome was implant stability, measured via insertion torque and implant stability quotient (ISQ). Secondary outcomes included marginal bone loss (MBL), implant survival, postoperative pain (visual analog scale [VAS]), analgesic consumption, and oral health-related quality of life (Oral Health Impact Profile, OHIP). Statistical analyses included t tests, Mann-Whitney U tests, chi-square tests, linear mixedeffects models, and Brunner-Langer models.

Primary stability was significantly higher in the osseodensification group; the ISQ values were 75.09 ± 7.87 in the osseodensification group versus 67.50 ± 10.89 in the osteotomy group (P = .013; mean difference: 7.59; 95% CI: 1.68-13.50). The torque was 32.95 ± 6.67 Ncm in the osseodensification group versus 26.25 ± 9.98 Ncm in the osteotomy group (P = .008; mean difference: 6.70; 95% CI: 1.87-11.53). Both groups had a 100% implant survival rate, and MBL was comparable (P = .459). Analgesic consumption was significantly lower in the osseodensification group (mean difference: -1.36, 95% CI: -2.44 to -0.28; P = .016). Lastly, OHIP scores were significantly lower after prosthetic loading in the osseodensification group (P = .008).

Osseodensification yielded greater primary stability and improved patient-reported outcomes compared to osteotomy, with similar implant survival and bone loss.