Osseodensification by Densah Burs Versus Osteotome for Transcrestal Maxillary Sinus Lifting With Simultaneous Implant Placement

Abstract

INTRODUCTION:Implant placement in the posterior maxilla is problematic, not only due to inferior properties of bone but also due to loss of vertical bone height which happens after extraction of posterior teeth. When the required additional height is few millimeters, indirect transcrestal sinus lifting procedures is recommended. This study was carried out to compare clinically transcrestal sinus lifting with Densah burs versus osteotome with simultaneous implant placement. MATERIALS AND METHODS:This study was designed to be randomized clinical trial, a total of 11 patients with missing maxillary premolars or molars and with limited vertical bone height below the maxillary sinus floor (5 to 8 mm) received 12 implants either with osteotome or with osseodensification transcrestal sinus lifting. The 11 patients were divided into 2 groups, group A received osseodensification sinus lifting, group B received osteotome sinus lifting. Clinical follow up was done over 6 months. Results: No significant difference was detected regarding postoperative pain and edema. The P value (0.002*) showed a statistically significant difference in the operation time between the 2 groups. The mean of primary stability in densah bur group was 66.17 ±9.57, while the mean in the osteotome group was 54.83 ±7.19. The P value was (0.043*) showed a significant difference in primary stability between both groups. Also there was a significant difference in secondary stability between the 2 groups. CONCLUSION: Both osseodensification and osteotome technique showed a good clinical outcome in 6 months follow up, with better implant stability in the osseodensification cases.

Effect of Different Crestal Sinus Lift Techniques for Implant Placement in the Posterior Maxilla of Deficient Height: A Randomized Clinical Trial

“…It is evident from the obtained results that the Densah group shows the highest mean implant primary stability; the osteotome group shows a lower mean value, and the piezosurgery group shows the lowest mean implant primary stability. This finding is similar to those of other studies [30,31] that demonstrated the highest implant stability to characterize the Densah group. However, our finding contradicts other studies that reported no significant difference concerning primary stability between the Densah and osteotome techniques [32,33].…”

Graftless Sinus Augmentation via Crestal Sinus Floor Elevation using Densah Burs with Simultaneous Implant Placement: A Clinical Report after Two Years in Service

“…19 El-Ghobashy also reported these results in 2022. 12 A few studies highlighted the critical condition and achieved proper CSFE utilizing osseodensification sinus elevation. In 2021, Salgar demonstrated a few cases of crestal window approach using Densah sinus lift protocols to substitute lateral window technique in hyper-pneumatized posterior maxilla with a RBH < 1.5 mm and then augmented the sinus with bone grafting up to 15 mm with simultaneous implant placements.…”

“…[6][7][8][9][10] Common CSFE includes utilizing osteotomes, piezosurgical units, SCA kits, CAS kits, DASK system, and novel osseous densification kits named Densah burs. 1,3,8,[11][12][13][14] CSFE via Densah burs was first proposed by Huwais et al in 2018. 11 These specific burs compact autogenous grafting during the osteotomy in a counterclockwise motion.…”

“…11,15 The reverse-cutting, as osseodensification mode (OD), compresses the osseous tissue into lateral walls and the apex of the preparation, creating a hydrodynamic compression toward the sinus floor and then causing a greenstick fracture and elevating the Schneiderian membrane as an indirect sinus lift. 3,11,12,[15][16][17][18] The bone-to-implant contact (BIC) is increased in low-density alveolar ridge while placing dental implants through this osseous densification, leading to the possibility of simultaneous implant placement during CSFE. 12,15,17,[19][20][21][22] To obtain a sufficient height of the alveolar ridge to place the implants, Both LSFE and CSFE combing the use of grafting materials have been accepted and proceeded as one of the standard methods.…”

“…3,11,12,[15][16][17][18] The bone-to-implant contact (BIC) is increased in low-density alveolar ridge while placing dental implants through this osseous densification, leading to the possibility of simultaneous implant placement during CSFE. 12,15,17,[19][20][21][22] To obtain a sufficient height of the alveolar ridge to place the implants, Both LSFE and CSFE combing the use of grafting materials have been accepted and proceeded as one of the standard methods. 2,3,23,24 Chen-Che Hung 1* and Ting-Chia Liu 2 However, recent studies have shown there is no significant difference in survival rate between placing conventional long implants with bone grafting and the graftless option using short implants.…”