Comparative Efficacy and Safety of Less-Invasive vs. Large Window Designs for Lateral Sinus Floor Elevation: A...

To determine whether lateral sinus floor elevation (LSFE) through a less-invasive window design (LIWD) can achieve (1) adequate sinus augmentation and (2) a safe procedure with reduced patient discomfort compared to a large window design (LWD).

Sixty LSFE (LIWD:30, LWD:30) with simultaneous implant installation were performed in a randomized controlled clinical trial on 60 subjects (75% males, mean age: 49.87±6.03) and followed for a mean of 30.7±0.41 months. Using CBCT (pre/post-operation), augmented bone height (primary outcome variable) and augmented bone length (secondary outcome variable) were measured to determine the adequacy of the augmentation. Perioperative complications were assessed to determine LIWD safety. The patient's postoperative quality of life (PPOQL) was also measured. Data were analyzed utilizing descriptive statistics, Chi-square tests, T-tests, and correlation analyses conducted with both Pearson and Spearman methods, with a significance level set at P-value< 0.05.

The LIWD and LWD groups' mean window sizes were 21.7±3.3 and 58.7±12.0 mm², with significant differences (P-value <0.001). The augmented bone height and length showed no significant difference between the groups (P-value= 0.824, P-value= 0.591). Also, there was no correlation between window size and augmented bone height (r=0.006,P-value=0.96) and length (r=0.063,P-value=0.632). Membrane perforation rates and surgical time showed similar results in both groups. The PPOQL measures revealed less discomfort (P-value<0.0001) in the LIWD group.

The LIWD provides a feasible, efficient, and safe approach for LSFE with adequate sinus augmentation. Reducing the window size does not increase surgical risks or duration. LIWD showed significantly less discomfort.