Bone Levels Are Preserved After Simultaneous Sinus Elevation at Time of Implant Placement


      The purpose of this study was to confirm that after simultaneous implant placement and vertical bone augmentation in the posterior maxilla, the immediate postoperative bone height is maintained after 2 to 3 years of follow-up.

      Patients and Methods

      Consecutive patients treated with implant placement in the posterior maxilla were evaluated. Cone-beam scans were taken preoperatively; immediately after implant placement; and for the sinus-grafted cases, 2 to 3 years after surgery. Crestal bone heights were measured. Patients were grouped according to the use of sinus augmentation or no sinus augmentation at the time of implant placement.


      The increase in bone height was significant in the graft group when we compared immediate and 3-year follow-up measurements (P < .00001). In the graft group, there were no significant differences in bone height when we compared the immediate and 3-year follow-up periods (P = .31).


      Simultaneous sinus floor elevation with grafting at implant placement results in stable bone levels after 2 to 3 years' follow-up.
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        • Fan T.
        • Li Y.
        • Deng W.W.
        • et al.
        Short implants (5 to 8 mm) versus longer implants (>8 mm) with sinus lifting in atrophic posterior maxilla: A meta-analysis of RCTs.
        Clin Implant Dent Relat Res. 2017; 19: 207
        • Lemos C.A.
        • Ferro-Alves M.L.
        • Okamoto R.
        • et al.
        Short dental implants versus standard dental implants placed in the posterior jaws: A systematic review and meta-analysis.
        J Dent. 2016; 47: 8
        • Pieri F.
        • Caselli E.
        • Forlivesi C.
        • Corinaldesi G.
        Rehabilitation of the atrophic posterior maxilla using splinted short implants or sinus augmentation with standard-length implants: A retrospective cohort study.
        Int J Oral Maxillofac Implants. 2016; 31: 1179
        • Pohl V.
        • Thoma D.S.S.
        • Porniak-Tutak K.
        • et al.
        Short dental implants (6 mm) versus long dental implants (11-15 mm) in combination with sinus floor elevation procedures: 3-Year results from a multicentre, randomized, controlled clinical trial.
        J Clin Periodontol. 2017; 44: 438
        • Bechara S.
        • Kubilius R.
        • Veronesi G.
        • et al.
        Short (6-mm) dental implants versus sinus floor elevation and placement of longer (≥10-mm) dental implants: A randomized controlled trial with a 3-year follow-up.
        Clin Oral Implants Res. 2017; 28: 1097
        • Fermergård R.
        • Astrand P.
        Osteotome sinus floor elevation and simultaneous placement of implants—A 1-year retrospective study with Astra Tech implants.
        Clin Implant Dent Relat Res. 2008; 10: 62
        • Schleier P.
        • Bierfreund G.
        • Schultze-Mosgau S.
        • et al.
        Simultaneous dental implant placement and endoscope-guided internal sinus floor elevation: 2-Year post-loading outcomes.
        Clin Oral Implants Res. 2008; 19: 1163
        • Zitzmann N.U.
        • Schärer P.
        Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 8
        • Toscano P.
        • Toscano C.
        • Del Fabbro M.
        Mini-invasive implant placement in combination with maxillary sinus membrane perforation during transcrestal sinus floor elevation: A retrospective study.
        Int J Periodontics Restorative Dent. 2016; 36: 199
        • Emmerich D.
        • Att W.
        • Stappert C.
        Sinus floor elevation using osteotomes: A systematic review and meta-analysis.
        J Periodontol. 2005; 76: 1237
        • Deporter D.
        • Todescan R.
        • Caudry S.
        Simplifying management of the posterior maxilla using short, porous-surfaced dental implants and simultaneous indirect sinus elevation.
        Int J Periodontics Restorative Dent. 2000; 20: 476
        • Spinato S.
        • Bernardello F.
        • Galindo-Moreno P.
        • Zaffe D.
        Maxillary sinus augmentation by crestal access: A retrospective study on cavity size and outcome correlation.
        Clin Oral Implants Res. 2015; 26: 1375
        • Cavicchia F.
        • Bravi F.
        • Petrelli G.
        Localized augmentation of the maxillary sinus floor through a coronal approach for the placement of implants.
        Int J Periodontics Restorative Dent. 2001; 21: 475
        • Ferrigno N.
        • Laureti M.
        • Fanali S.
        Dental implants placement in conjunction with osteotome sinus floor elevation: A 12-year life-table analysis from a prospective study on 588 ITI implants.
        Clin Oral Implants Res. 2006; 17: 194
        • Block M.S.
        Improvements in the crestal osteotome approach have decreased the need for the lateral window approach to augment the maxilla.
        J Oral Maxillofac Surg. 2016; 74: 2169
        • Block M.S.
        • Emery R.W.
        • Lank K.
        • Ryan J.
        Implant placement accuracy using dynamic navigation.
        Int J Oral Maxillofac Implants. 2017; 32: 92
        • Block M.S.
        • Emery R.W.
        • Cullum D.R.
        • Sheikh A.
        Implant placement is more accurate using dynamic navigation.
        J Oral Maxillofac Surg. 2017; 75: 1377
        • Block M.S.
        The processing of xenografts will result in different clinical responses.
        J Oral Maxillofac Surg. 2019; 77: 690
        • Jensen O.T.
        • Shulman L.B.
        • Block M.S.
        • Iacono V.J.
        Report of the sinus consensus conference of 1996.
        Int J Oral Maxillofac Implants. 1998; 13: 11
        • Lussi H.
        • Geislich P.
        Process for preparing high purity bone material.
        (US Patent 5,167,961)December 1, 1992
        • Gultekin B.A.
        • Cansiz E.
        • Boraharn O.
        • et al.
        Evaluation of volumetric changes of augmented maxillary sinus with different bone grafting biomaterials.
        J Craniofac Surg. 2016; 27: e144
        • Kanayama T.
        • Horii K.
        • Senga Y.
        • Shibuya Y.
        Crestal approach to sinus floor elevation for atrophic maxilla using platelet-rich fibrin as the only grafting material: A 1-year prospective study.
        Implant Dent. 2016; 25: 32
        • Pérez-Martínez S.
        • Martorell-Calatayud L.
        • Peñarrocha-Oltra D.
        • et al.
        Indirect sinus lift without bone graft material: Systematic review and meta-analysis.
        J Clin Exp Dent. 2015; 7: e316
        • Nedir R.
        • Nurdin N.
        • Vazquez L.
        • et al.
        Osteotome sinus floor elevation without grafting: A 10-year prospective study.
        Clin Implant Dent Relat Res. 2016; 18: 609
        • Brizuela A.
        • Martín N.
        • Fernández-Gonzalez F.J.
        • et al.
        Osteotome sinus floor elevation without grafting material: Results of a 2-year prospective study.
        J Clin Exp Dent. 2014; 6: e479
        • Isidori M.
        • Genty C.
        • David-Tchouda S.
        • Fortin T.
        Sinus floor elevation with a crestal approach using a press-fit bone block: A case series.
        Int J Oral Maxillofac Surg. 2015; 44: 1152
        • Rosen P.S.
        • Summers R.
        • Mellado J.R.
        • et al.
        The bone-added osteotome sinus floor elevation technique: Multicenter retrospective report of consecutively treated patients.
        Int J Oral Maxillofac Implants. 1999; 14: 853
        • Patel S.
        • Lee D.
        • Shiffler K.
        • et al.
        Resonance frequency analysis of sinus augmentation by osteotome sinus floor elevation and lateral window technique.
        J Oral Maxillofac Surg. 2015; 73: 1920