Graftless Sinus Floor Elevation Using the Lateral or Transcrestal Approach. A Randomized Clinical Trial With One Year...

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Bone Regeneration

Background:

• Maxillary sinus floor elevation (MSFE) is crucial for dental implant placement in the posterior maxilla.
• Graftless techniques aim to simplify MSFE, but comparisons between lateral window and crestal approaches are ongoing.
• Evaluating long-term implant stability and bone regeneration is essential for treatment success.

Purpose of the Study:

• To compare implant stability between graftless lateral window and crestal implant approaches for MSFE.
• To assess intra-sinus vertical bone gain and marginal bone loss at 1 year post-implantation.
• To evaluate clinical parameters and patient-reported outcomes for both MSFE techniques.

Main Methods:

• A randomized clinical trial involving 26 patients with a residual ridge height of 4-6 mm undergoing delayed implant placement.
• Patients were randomly assigned to either the graftless lateral window (control) or crestal implant (test) approach for MSFE.
• Implant stability (Resonance Frequency Analysis), vertical bone gain and marginal bone loss (CBCT), and clinical parameters were assessed at 12 months.

Main Results:

• No significant difference in implant stability quotient (ISQ) was found between the lateral window (80.92 ± 4.57) and crestal implant (80.19 ± 7.28) groups at 12 months.
• The lateral window approach achieved significantly greater intra-sinus vertical bone gain (3.64 ± 0.84 mm at 6 months, 3.82 ± 0.84 mm at 12 months) compared to the crestal approach (1.66 ± 1.27 mm at 6 months, 2.42 ± 1.39 mm at 12 months).
• No significant difference in marginal bone loss was observed between groups after 12 months, but the lateral window group reported more postoperative complications and patient discomfort.

Conclusions:

• Graftless lateral window and transcrestal sinus approaches yield comparable implant stability at 12 months for MSFE in patients with 4-6 mm residual ridge height.
• The lateral window technique demonstrates superior vertical bone augmentation in the maxillary sinus.
• While effective for bone gain, the lateral window approach is associated with increased postoperative complications and patient discomfort compared to the crestal approach.