Osteotome Sinus Floor Elevation Technique Without Grafting:a Prospective Clinical Study

Objective:This clinical study aimed(1)to evaluate the clinical success of placing dental implants simultaneously using osteotome sinus floor elevation(OSFE)technique without grafting in the posterior maxilla and(2)to observe the bone changes in the elevated space with OSFE without grafting.Material and methods:173Straumann(?) implants were placed in the posterior maxillae of126patients using OSFE.146implants were placed in105patients without grafting, and27implants were placed in21patients with hydroxyapatite(HA).The implants were allowed to heal for3-4months for non-grafted implants and for6-8months for grafted cases.For radiographic analyses,panoramic radiographs were taken of all patients at preoperative,immediate postoperative, preprosthetive, postprosthetive annually to assess the bone changes for the elevated sites with or without grafting.Results:126patients all did not happened the complications of the maxillary sinusitis during the follow up period;169implants were stable,the implants fulfilling the survival criteria represented a cumulative survival rate of97.69%.The residual bone height (RBH) was6.41±1.34mm for the non-grafted group and6.95±1.52mm for the grafted group,the cumulative survival rate of97.95%and96.29%,respectively. No significant differences were found between the two groups in RBH and survival rate.44implants of33patients were elected to the radiographic analyses.The RBH was6.11±0.74mm. The postoperative radiographs showed the maxillary sinus floors were elevated by3.11±1.11mm,the radiographic analyses demonstrated that new bone formation in the elevated sinus was visible of all implants and the endo-sinus bone gain was1.73±0.65mm and1.83±0.68mm at postoperative and loading1-year; the implant protrusion length was decreased with the new bone formation.At the follow-up,the endo-sinus bone gain were not significantly correlated to RBH;but it was significantly correlated to the implant protrusion length.Conclusions:The findings of this study indicated that with complying with suitable surgical indication and a standard technique, a good clinical results and a high success rate can be obtained applying osteotome sinus floor elevation technique without bone grafting and placing implants simultaneously. Uneventful osseointegration may be predictable on using OSFE whether with or without bone grafting in atrophic posterior maxilla. Spontaneous new bone formation seemed to be expected with implants placed using OSFE without grafting.