Impact of small antral pseudocyst interventions on bone remodeling during sinus floor elevation: a retrospective...

The study aims to assess the effects of different treatments on postoperative hard tissue surrounding implants. This will be achieved through a retrospective analysis of patients with small antral pseudocysts (APs) measuring 20 mm or less, who received various management strategies for APs during lateral maxillary sinus floor elevation (LSFE).

This retrospective study examined 107 patients who underwent LSFE with concurrent implant placement, categorized into removal, aspiration, and untreated groups. The three-dimensional volumetric change rate of the bone graft within the maxillary sinus, the endo-sinus bone gain (ESBG), apical bone height (ABH), and peri-implant bone height (PBH) were assessed to quantify bone volume change. The marginal bone loss (MBL) and implant failure rate were evaluated to compare the success rates of implant surgery.

All implants demonstrated functionality without any failure or occurrences of sinusitis. Six months after surgery, the untreated group exhibited a significant reduction in bone graft volume (-18.31% [-19.72%, -15.24%]) compared to the removal group (-14.11% [-17.42%, -11.05%]) and the aspiration group (-16.55% [-18.71%, -11.83%]) (P < .001), alongside greater changes in ESBG and ABH (P < .01). PBH and MBL exhibited comparable values across the groups. Over a period of two years, bone graft stability was maintained, whereas, PBH exhibited a significant increase from six months to one year.

The findings of our study suggested that in LSFE, routine removal of small APs (diameter ≤ 20 mm), might be not required. A conservative treatment strategy for APs was advised to streamline the surgical procedure and enhance the success rate of implantation.