Patient Perception and Radiographic Assessment of Sinus Lifting Procedure using Densah Bur versus Osteotome-mediated sinus lifting: A Randomized Clinical Trial

Salma Eiid,Doaa Rostom

doi:10.21608/adjc.2021.31321.1069

Abstract

Aim: This study aimed to evaluate the clinical complications that might be presented with osteotome and densah burs, as well as to assess the new bone generated at 6 months post-operatively using CBCT. The study hypothesis was that densah bur would show comparable results to osteotome-mediated sinus lifting. Material and method: Ten patients were enrolled in the study with atrophied maxillary posterior edentulous area that required rehabilitation with implants and sinus membrane elevation. Sinus membrane was elevated with two techniques, Osteotome and Densah bur sinus lifting procedures. Clinical (sinus perforation, post-operative swelling, and headache/vertigo) and radiographic parameters (RBH and ESBG) were assessed. Result: In both groups, new bone levels were higher in comparison to initial levels with statistical significant difference. The mean RBH in Densah bur group (8.1 ± 1.5) was higher than the Osteotome group (6.9 ± 0.6) with p value = 0.13. Moreover, Densah bur showed higher mean ESPG than group I with 1.8 ± 0.4 and 1.4 ± 0.5 values respectively and p value = 0.21. Lastly, post-operative complications comparison showed non-significant differences between both groups except for headache and vertigo. Conclusion: The protruded implants can act as tents and allow formation of blood clot with concomitant bone regeneration. Although the two techniques applied for drilling showed comparable radiographic results, however, they displayed differences in patient perception. According to this study, it can be concluded that osseodensification surpasses osteotome- lifting procedure when it comes to patient comfort and satisfaction.

Highlights

Maxillary posterior edentulous area rehabilitation with implants is usually not an easy procedure and is considered a challenge to many prosthodontists
This study aimed to evaluate patient perception to osteotome and densah burs, as well as to assess the new bone generated at 6 months post-operatively using cone beam computed tomography (CBCT)
A meta-analysis in 2019 stated that the intra and postoperative complications that might occur with osteotomemediated lifting procedure are infection, exposure of the covering membrane, swelling, mild postoperative edema, pain, nose bleeding, headache and vertigo

Summary

Introduction

Maxillary posterior edentulous area rehabilitation with implants is usually not an easy procedure and is considered a challenge to many prosthodontists. This is due to pneumatization of the maxillary sinus, poor bone density and volume, and difficult accessibility of this area. Summer in 1994 introduced a less invasive technique than the conventional lateral approach sinus floor elevation called the closed sinus lifting. Summer classified it in to osteotome sinus floor elevation and bone-added osteotome sinus floor elevation. Being successful and non-invasive, Summer’s technique showed several surgical problems as heat generation-induced necrosis if not well irrigated, delayed implant secondary stability, and some patient-related drawbacks as headache and vertigo.[3]

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