The comparative evaluation of transcrestal and lateral sinus floor elevation in sites with residual bone height ≤6 mm: A two-year prospective randomized study.

Abstract

To compare clinical and radiographic outcomes between transcrestal sinus floor elevation (TSFE) and lateral sinus floor elevation (LSFE) approaches of simultaneous implant placement in atrophic maxilla. Patients with a residual bone height (RBH) ≤6mm were enrolled and randomly assigned to TSFE and LSFE groups. Patients in both groups simultaneously underwent sinus floor elevation with bovine-derived xenograft and implant placement. Clinical and radiographic results were evaluated immediately after surgery and after 6, 12, 18, and 24months. The endo-sinus bone gain (ESBG), apical implant bone height (ABH), endo-sinus bone-implant contact rate (EBICR), and crestal bone level (CBL) were assessed using panoramic radiographs. Forty-one implants (TSFE: 21, LSFE: 20) were placed in cases with a mean RBH of 3.77±1.16mm. All implants obtained clinical success and satisfactory ESBG at 24months. No significant differences were found in ESBG and ABH between two groups immediately after surgery, but LSFE group showed significantly higher values than TSFE group thereafter. Grafts in TSFE group reached stability 6months earlier than that in LSFE group. In both groups, EBICR was almost 100%, and CBL showed no detectable changes. LSFE can achieve higher ESBG 2years after surgery. Otherwise, TSFE could be an alternative to LSFE, when the access for lateral window preparation is limited. Both approaches were highly predictable for RBH≤6mm during 24-month observation period for the implants placed simultaneously.