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Graftless Sinus Floor Elevation Using the Lateral or Transcrestal Approach. A Randomized Clinical Trial With One Year
Ahmed Ibrahim Aboul Fettouh1, Noha Ayman Ghallab2, Nael Adel3
1Executive and Clinical Director Master Implantology Program, Faculty of Dentistry, Misr International University, Cairo, Egypt.
Introduction:
This randomized clinical trial aimed to evaluate implant stability following graftless lateral window and crestal implant approaches for maxillary sinus floor elevation (MSFE) 1 year after implant placement.
Methods:
Twenty-six single missing posterior maxillary teeth indicated for delayed implant placement, with a residual ridge height of 4-6 mm, were randomly assigned to perform either graftless lateral window (control) or crestal implant (test) approaches for MSFE. Implant stability was assessed using resonance frequency analysis; intra-sinus vertical bone gain and marginal bone loss were measured via CBCT 1 year after implant placement. Clinical parameters and patient-reported outcomes were also measured.
Results:
The reported implant stability quotient (ISQ) values were not significantly different between the lateral window and the crestal implant approaches (80.92 ± 4.57 and 80.19 ± 7.28, respectively) 12 months after implant placement. However, the lateral window approach revealed a significant increase (p < 0.001) in the mean ± SD intra-sinus vertical bone gain at 6 and 12 months (3.64 ± 0.84 mm and 3.82 ± 0.84 mm, respectively) compared to the crestal implant approach (1.66 ± 1.27 mm and 2.42 ± 1.39 mm, respectively). However, no intergroup significant difference was noticed concerning average marginal bone loss (p = 0.31) after 12 months. Postoperative complications and patient discomfort were more evident in the lateral window approach group.
Conclusion:
In patients with a residual ridge height of 4-6 mm receiving implant therapy in conjunction with maxillary sinus elevation without graft material, there was no statistically significant difference in implant stability at 12 months between a lateral window and transcrestal sinus approach. Greater vertical bone gain was achieved following the lateral window approach.
