Radiographic outcomes of transcrestal and lateral sinus floor elevation: One‐year results of a bi‐center, parallel‐arm randomized trial

Abstract

Objectives To comparatively evaluate the radiographic outcomes of transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively) when applied concomitantly with implant placement. Materials and methods Patients with at least 1 edentulous site with residual bone height (RBH) of 3–6 mm were enrolled in a bi‐center, parallel‐arm, randomized trial. Both tSFE and lSFE were associated with a bovine‐derived xenograft, and implants were inserted concomitantly. In lSFE group, the antrostomy was covered with a resorbable collagen membrane. Marginal bone loss and the maturation of the grafted area were evaluated on periapical radiographs at 6 and 12 months. Twelve‐month CT/CBCT was used to assess the effect of grafting procedures circumferentially around the implant. A per‐protocol analysis was performed. Results The per‐protocol study population consisted of 26 patients in the tSFE group and 28 patients in the lSFE group. At 12 months, the median proportion of the implant surface in contact with the peri‐implant radiopaque area was 100% in both groups, with no significant inter‐group difference. Suboptimal bone‐to‐implant contact was observed in 13% and 3.6% of tSFE and lSFE cases, respectively. In both groups, marginal bone loss was minimal (≤1 mm) and infrequent, and the radiographic aspect was suggestive of an advanced stage of maturation. Conclusions At sites with RBH of 3–6 mm where implants are placed concomitantly with sinus floor elevation, tSFE and lSFE are both highly predictable in obtaining an implant surface completely embedded in a radiopaque area at 12 months post‐surgery. (ClinicalTrials.gov ID: NCT02415946).

The impact of graft remodeling on peri‐implant bone support at implants placed concomitantly with transcrestal sinus floor elevation: A multicenter, retrospective case series

“…The study protocol was approved by the Local Ethical Committee of Ferrara, Italy (protocol number: 170194). Surgical procedures were performed at the Research Centre for the Study of Periodontal and Peri‐implant Diseases, University of Ferrara, Italy, and 3 private dental offices involved in previous clinical trials on the tSFE procedure used in this study (Farina et al, , ; Franceschetti, Farina, Minenna, Franceschetti, & Trombelli, ; Franceschetti et al, , ; Trombelli et al, , , ; Trombelli, Minenna, Franceschetti, Minenna, & Farina, ).…”

“…The preparation of the implant site was performed according to a minimally invasive procedure for tSFE, namely the Smart Lift technique (Trombelli et al, ; Trombelli, Minenna, Franceschetti, Minenna, & Farina, ; Trombelli, Minenna, Franceschetti, Minenna, Itro, et al, ; Figure ). The technique is based on a standardized sequence of specially designed rotating and manual instruments that are used with stop devices (Farina et al, , ; Franceschetti et al, , , ; Trombelli et al, , , , ; Trombelli, Minenna, Franceschetti, Minenna, & Farina, ; Trombelli, Minenna, Franceschetti, Minenna, Itro, et al, ).…”

“…At the operator's discretion, the elevation of the sinus floor was performed with BC either alone as autogenous graft material or supplemented by a xenogeneic or synthetic graft biomaterial placed into the sinus by gradual increments using the osteotome. When another graft material was used in addition to BC, it was selected by the operator among the followings: deproteinized bovine bone mineral (DBBM; Bio‐Oss ® spongiosa granules 0.25–1.0 mm; Geistlich Pharma, AG); deproteinized porcine bone mineral (DPBM; Gen‐Os ® cortical and spongiosa granules 0.25–1.0 mm; Osteobiol Tecnoss Dental); synthetic hydroxyapatite in a collagen matrix (S‐HA; Biostite ® ; GABA Vebas, S); or ß‐tricalcium phosphate (ß‐TCP; Ceros ® , granules 0.5–0.7 mm; Thommen Medical), and its amount was pre‐determined in relation to the extent of sinus floor elevation that had to be achieved (Farina et al, , ; Franceschetti et al, ; Trombelli et al, , ).…”

“…All available radiographs were scanned, digitized, stored at a resolution of 600 dpi, and analyzed using an image processing software (NIS Elements ® v4.2; Nikon Instruments). All radiographic measurements were performed by a single trained examiner (G.F.) who had previously undergone a calibration session for linear radiographic measurements on a sample of 15 patients not included in the study and had participated as clinical examiner in previous clinical trials on tSFE (Farina et al, , ; Franceschetti et al, , , ; Trombelli et al, ).…”

“…To account for radiographic distortion, linear measurements taken on each radiograph were adjusted for a coefficient derived from the ratio: true length of the implant/ radiographic implant length (rIL) (Farina et al, , ; Franceschetti et al, , , ; Trombelli et al, , , ).…”