Efficacy of Different Techniques of Crestal Sinus Lifting

Summary

Twenty one patients with deficient posterior maxilla and alveolar bone height ≤ 5mm were included.Those patients randomly divided into 3 equal groups:

1. Group 1: 7 patients treated by osteotome closed sinus lift with bone grafting (xenograft) and implant placement.
2. Group 2: 7 patients treated by densah burs(Versah, Jackson, MI, USA) sinus lift with bone grafting (xenograft) and implant placement.
3. Group 3: 7 patients treated by piezoelectric (Piezotome; Satelec) crestal sinus lift with bone grafting (xenograft) and implant placement.

Conditions

• Maxillary Sinus Augmentation

Interventions

PROCEDURE

osteotome crestal sinus lifting

Full thickness flap elevated to expose the crest of alveolar ridge. Pilot drill used to start the osteotomy preparation, which should be ended 1mm short of sinus floor. The drills can be sequentially used to widen the osteotomy site to the same level (1 mm short of the sinus floor), an osteotome of diameter a little less than the planned implant body, will be inserted in the prepared osteotomy site and gently tapped to reach the same level, the osteotome will be tapped gently to fracture up the sinus floor.Clinical check for membrane still intact, blocking the patient's nostrils and asking the patient to blow through his or her nose. Xenograft will be added as the grafting material and pushed to the sinus through the osteotomy site until the desired height of sinus elevation will be gained, the implant fixture will be inserted. Smart peg will be placed on implant and Ostell will be used to record ISQ.

PROCEDURE

osseodensification crestal sinus lifting

Full thickness flap elevated to expose the crest of alveolar ridge. Pilot drill used to start the osteotomy preparation, which should be ended 1mm short of sinus floor. Change the drill motor to reverse-densifying Mode (counterclockwise drill speed 800-1500 rpm with copious irrigation), Begin with the densah bur (2.5mm) until 1 mm short of the sinus floor, use the next wider Densah Bur (3.0mm) in the same mode and advance it into the previously created osteotomy with modulating pressure and a pumping motion. When feeling the haptic feedback of the drill reaching the dense sinus floor, modulate pressure with a gentle pumping motion to advance past the sinus floor in 1 mm increments, the next wider densah drills advance in the osteotomy.Clinical check for membrane still intact. Xenograft added and pushed to the sinus through the osteotomy site then the implant fixture will be inserted.

PROCEDURE

piezoelectric crestal sinus lifting

initial osteotomy will be performed with a 2-mm twist drill to remove the cortical bone, then the intralift tips (Intralift; TKW1, TKW2, TKW3,TKW4, TKW5; Satelec). TKW1 to TKW4 tips have diameters of 1.35 mm, 2.1 mm, 2.35 mm, and 2.8 mm and will be used to gradually widen the access canal to the Schneider membrane, gentle pressure will be applied on the tips to deepen the pathway, and a sterile spray (80 mL/min) cooling the tips to avoid heat injury. The TKW5 tip will be then inserted into the access canal, and the ultrasonic activation for 5 seconds with internal irrigation of 40 mL/min and repeated at 50 mL/min and then 60 mL/min. The sinus membrane will be pushed upward by the hydraulic pressure, the floating of the sinus membrane will be evaluated, and then the TKW4 (Ø 2.8 mm) will be used again to widen the access canal to the sinus membrane before plugging the bone graft.xenograft added. Implant fixture inserted and flap statured

Sponsors & Collaborators

• Al-Azhar University

  lead OTHER

Principal Investigators

• Ahmed H. Hashem, Ass.Leturer · Al-Azhar University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2020-01-15

Primary Completion

2022-03-30

Completion

2022-04-28

Countries

• Egypt

Study Locations