Clinical Research Of Flapless Technique In Transalveolar Sinus Floor Elevation

ObjectiveThe aim of this study is to evaluate the outcomes of transalveolar sinusfloor elevation combined with flapless technique.Material and Methods: Between February2010and August2012, fifty-oneconsecutive patients in need of maxillary sinus floor augmentation were enrolled in thisstudy. They were randomly divided into flapless group if their register number is an oddnumber, others were in flap group. The VAS value was recorded in pre-operation,operation, the day of surgery continued to the third day after surgery. Patients werefollowed up clinically, intraoral and panoramic radiographs were taken before surgery,after the surgery and at the sixth month after surgery. Record the Residual bone height(RBH), Endo-sinus implant length (EIL), Crestal bone loss (CBL), Sinus floor liftheight (SLH), and compare the differences between the flapless group and flap group.Record the insertion torque. Any postoperative complications, including infection,membrane perforation, and implant loss were recorded. Input the statistics into SPSS19.0, compared between the flapless group and flap group. If p＜0.05, there issignificant difference.Results:25patients were included in the flapless group and had28sinus floorelevation,28implants were inserted.26patients were included in the flap group with28sinus floor elevation,28implants were inserted. RBH in flapless group is7.79±1.05mmand7.61±1.12mm in flap group, p=0.550. The VAS mean value of pre-operation,operation, the day of surgery, the day after surgery is4.20,2.64,3.04,2.00in theflapless group, and5.46,4.31,4.27,3.46in the flap group, VAS in the flapless group islower than that in the flap group, p＜0.05. The painless patients accounts for72％atthe second day and100％at the third day in the flapless group. In flap group the rate is50％and76.92％. The flapless group shows a faster absence of discomfort, p＜0.05.The SLH in flapless group is4.65±1.45mm and in flap group is4.84±1.53mm, there is no significant difference, p=0.482. So is EIL between flapless group (2.27±0.93mm)and flap group (2.54±1.05mm), p=0.307. But there is significant difference at CBLbetween flapless group (0.55±0.08mm) and flap group (0.84±0.10mm), p＜0.05. Allimplants displayed primary stability with a mean insertion torque≥15N·cm. There is nopost-surgery complications in the flapless group but in the flap group there are3gingival bleedings.Conclusions:1. Flapless technique may decrease pain and the occurrence ofpost-surgery complications such as bleeding, promoting the healing of gingiva.2.Flapless technique can help preserving the marginal bone around implant.3. Flaplesstechnique has no retroaction at the accuracy and outcome of sinus floor elevation.4. Inproper patients, there is priority to perform flapless sinus floor elevation than traditionalflap method.