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International Journal of Periodontics & Restorative Dentistry
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Int J Periodontics Restorative Dent 38 (2018), No. 4     18. June 2018
Int J Periodontics Restorative Dent 38 (2018), No. 4  (18.06.2018)

Page 593-599, doi:10.11607/prd.3403, PubMed:29889923


Maxillary Sinus Membrane Elevation Using a Special Drilling System and Hydraulic Pressure: A 2-Year Prospective Cohort Study
Gatti, Fulvio / Gatti, Claudio / Tallarico, Marco / Tommasato, Grazia / Meloni, Silvio Mario / Chiapasco, Matteo
The purpose of this study was to evaluate clinical and radiologic outcomes using a newly developed device for maxillary sinus membrane elevation. Patients with a residual bone height of at least 3 mm were enrolled. Crestal sinus lift elevation and sinus graft were performed using the crestal approach sinus (CAS) kit. Graft was avoided if the residual bone crest was ≤ 2 mm less than the length of the planned implant. Outcome measures were implant and prosthesis failure, any biologic or technical complications, and marginal bone loss (MBL). A total of 35 consecutive patients underwent 49 crestal elevations of the sinus membrane. All the implants were followed for at least 2 years after placement (mean follow-up 37.3 months; range 24 to 54 months). No implants or prostheses failed during follow-up, and no membrane tears or other intraoperative or postoperative adverse events were observed. At the 2-year follow-up, mean MBL was 0.33 ± 0.24 mm (95% confidence interval: 0.08 to 0.30 mm). A total of 32 implants were placed after filling the sinus with anorganic bovine bone, while 17 implants were placed without grafting the sinus. Post-hoc analysis was performed using the sinus grafting remodeling index (SGRI) to evaluate radiographically the tissue remodeling patterns. The SGRI was statistically significantly higher when the sinus was grafted (P = .000). The CAS kit may provide a new option for minimally invasive crestal sinus surgery. Long-term randomized controlled trials with larger sample size are needed to confirm these preliminary results.