The assessment of the effect of the size of lateral‐antrostomy in graftless balloon elevation of the maxillary sinus membrane with simultaneous implant placement (a randomized controlled clinical trial)

Abstract

Background The overlying maxillary sinus frequently restrains the height of the posterior maxillary bones. Purpose Evaluating the effect of downsizing the antrostomy side‐window on the stability of the installed implants and vertical bone gain, after employing a graftless antral membrane balloon elevation (AMBE). Materials and methods The study is a randomized controlled clinical trial conducted on 20 patients with 30 deficient maxillary alveolar ridges underwent graftless (AMBE) after being allocated into a (5 mm) entry antrostomy group (the test group) and a (10 mm) entry antrostomy group (the control group) implementing a radiographic linear bone height and implant stability quotations (ISQ) comparison among both groups immediately after the placement of 38 Implants and 6 months after. Results Radiographic bone gain of the test group (5.55 ± 0.93 mm) was significantly higher than the control group (2.86 ± 0.60 mm) (p <0.001). There was no significant difference in primary stability between the test (65 ± 5.32) and control groups (62.67 ± 4.46) (p = 0.202); while the test group (73.43 ± 4.39) showed significantly higher secondary stability than the control group (64.83 ± 6.05) (p <0.001). ISQ values recorded at 6 months were significantly higher than those recorded at insertion in the test group (p <0.001), while they were insignificant in the control group (p = 0.148). Conclusion Undersizing the antrostomy window deemed beneficial concerning the vertical bone gain and the simultaneously placed root form dental implants' secondary stability.

Repositioning of the bone window in lateral sinus floor elevation with simultaneous implant placement: A retrospective radiographic study

“…In the current application of LSFE, a common procedure for preparing the accessing window is to directly grind the lateral wall bone using the rotary diamond round bur, but the remaining lateral defect is reported to have an adverse effect on endo-sinus bone healing (Yu & Qiu, 2017). In addition, current studies have shown that a smaller lateral window contributes to the early bone formation compared with a larger window whether undergoing grafting or not (Aldahouk et al, 2021;Zhu et al, 2021), which confirms the role of the lateral bone wall in endo-sinus bone augmentation. Besides, the residual lateral defect caused by the round bur would lead to the compensation of graft material to fill the lateral antrostomy hole, which might affect the endo-sinus augmentation effect of LSFE (Zhou et al, 2021; Figure 1a).…”

“…A recent histomorphometric study in rabbits found that repositioning of the bone window could accelerate endo-sinus bone generation and generate more new bone (31.28 ± 3.51% vs. 21.74 ± 2.40%; p < .05) and mature bone (27.37 ± 5.45% vs. 13.02 ± 3.69%; p < .05) at 8 weeks compared with the collagen membrane-covered group (Moon et al, 2014), proving the osteoinductive efficacy of the lateral wall bone. Other studies assessing the effect of the size of lateral wall antrostomy on endosinus bone formation also confirmed the above conclusion that lateral wall bone had a role of osteoinduction and acted as the source of osteogenesis, providing growth factors and a blood supply for bone regeneration (Aldahouk et al, 2021;Avila-Ortiz et al, 2012;Yu & Qiu, 2017;Zhu et al, 2021). The above studies were in agreement with the results in this study, demonstrating that the repositioned bone wall would be beneficial to the graft stability, especially to the region near the bone window.…”

“…For example, LWT might influence patient selection as patients with thicker bone walls might be selected for the repositioned group. And the size of lateral osteotomy was also reported to affect the endo‐sinus bone healing, because a smaller lateral window would contribute to the early bone formation compared with a larger one (Aldahouk et al, 2021). In this present study, the above sinus anatomical factors and lateral osteotomy dimension factors (including the window surface area and the window thickness) were measured and analyzed.…”

Minimally invasive techniques for lateral maxillary sinus floor elevation: small lateral window and one-stage surgery—A 2- to 5-year retrospective study

“…Lately, cone-beam computed tomography (CBCT) has been considered as a promising three-dimensional (3D) option in evaluating the extent of peri-implant bone augmentation surrounding the implant 14,23,27,30 . However, 3D analysis of the grafted area of lSFE with a small window and minimally invasive techniques for lSFE are scant and have short follow-up periods 14,30,31 . In the consistence of these studies, authors veri ed that the stability of implants and excellent osteogenic capacities were detected 6 months after small antrostomy surgery.…”

“…To assess the periimplant bone augmentation, various imaging approaches have been utilized 29 . Lately, cone-beam computed tomography (CBCT) has been considered as a promising three-dimensional (3D) option in evaluating the extent of peri-implant bone augmentation surrounding the implant 14,23,27,30 . However, 3D analysis of the grafted area of lSFE with a small window and minimally invasive techniques for lSFE are scant and have short follow-up periods 14,30,31 .…”