Clinical and Radiographic Evaluation of Modified Transalveolar Two-Step Osteotome-Mediated Localized Maxillary Sinus Elevation: A Retrospective Computed Tomography Study with a 3-Year Follow-up.

Abstract

This study aimed to report a practicable and noninvasive two-stage technique for sinus elevation and delayed implant insertion in the augmented site with residual bone height down to 3 mm or even lower. The surgical technique employed a two-stage process for rehabilitation of posterior maxillary single-tooth edentulous areas, involving, in the first step, transcrestal maxillary sinus floor augmentation with a collagen sponge to fill the intrabony cavity resulting from the detachment of the sinus membrane; the second step consisted of another indirect sinus floor elevation using magnetoelectric surgery with immediate implant placement and no grafting material. Changes in bone height were evaluated by a comparison of the computed tomography scans acquired before treatment and after surgery (at 3 months and 5 years of the survey). Statistically significant differences between the times and the tooth sites were evaluated by nonparametric statistics (matched and independent), with P < .01. Forty patients were retrospectively selected. The preoperative height of the available alveolar bone was 2.9 ± 0.6 mm. A significant increase in bone height (P < .01) was found for both the first and the second surgery (3.1 ± 0.6 mm and 4.4 ± 0.6 mm, respectively). The overall bone height was measured at 3 years after the first surgery (10.3 ± 0.6 mm). Measurements of the bone height ranked for tooth positions showed no significant difference between premolars and molars. None of the selected patients registered an implant failure. Two-stage osteotome-mediated sinus elevation appeared to be a predictable technique that enabled practitioners to increase the bone height and to obtain successful outcomes even if the amount of bone was approximately 3 mm in height.