Double Transcrestal Sinus Lift Procedure with Collagen as Bone Void Filler Alone in Atrophic Maxilla: 5 Years Retrospective Radiological Study

Abstract

Objectives: The present study aimed to investigate the effectiveness of transcrestal double-elevation of the maxillary sinus (TSFE) with an implant placement during the second-stage surgery in the maxillary areas with a residual alveolar bone less than 3mm. Materials and Methods: Patients with long-standing edentulous areas underwent double TSFE surgery involving a first transcrestal maxillary sinus floor augmentation with a collagen sponge to fill the intrabony cavity and a second osteotome-mediated sinus floor elevation by using an electromagnetic device and immediate implant placement. The radiographic changes in bone heightwere measured and compared during the different time intervals by nonparametric statistics with p < 0.01. Results: Twenty-eight patients were retrospectively selected for the study. A total of 42 implants were positioned in 28 augmented sinuses. After the first TSFE surgery, no minor swelling of gingival mucosa, no mucositis, or flap dehiscence with suppuration was found. After three months a second TSFE with simultaneous implant placement was performed; four patients experienced minor nasal bleeding. Significant increases in the bone height had been respectively reported for the first (from 2.3±0.2 to 9.5 ± 0.3 mm) and second surgeries with p-values less than 0.0001 and an overall bone height measured 5 years after the first surgery of 12.2±0.3 mm. Conclusion: The present study suggested to clinicians the possibility of osteotome double sinus lifting and grafting with highly absorbable collagen material, generally used as a haemostatic agent alone in case of residual bone height less than 3 mm.