Patient Perception and Radiographic Assessment of Sinus Lifting Procedure
Condition: Dental Implant Failed
Study type: Interventional

Summary: 
      This study aimed to evaluate the clinical complications that might be presented with
      osteotome and densah burs, as well as to assess the new bone generated at 6 months
      post-operatively using CBCT. The study hypothesis was that densah bur would show comparable
      results to osteotome-mediated sinus lifting
    

Detailed description: 
      Maxillary posterior edentulous area rehabilitation with implants is usually not an easy
      procedure and is considered a challenge to many prosthodontists. This is due to
      pneumatization of the maxillary sinus, poor bone density and volume, and difficult
      accessibility of this area. After tooth loss, the maxillary sinus tends to enlarge into the
      remaining residual ridge because of poor bone density and lack of functional stimulation by
      teeth.1 Rehabilitation with dental implants in the maxillary posterior area depends on the
      quantity and quality of bone available for implant placement. In order to place the implant
      in the best prosthetic position, regenerative surgical techniques are usually essential to
      correct the initial anatomical situation.2 Summer in 1994 introduced a less invasive
      technique than the lateral approach for sinus floor elevation, called the closed sinus
      lifting. Summer classified it in to osteotome sinus floor elevation and bone added osteotome
      sinus floor elevation. Osteotome depends on condensing the bone in implant bed site and
      pushing it laterally and upward, which raises the sinus floor. Although being successful and
      non-invasive, Summer's technique showed several surgical problems as heat generation-induced
      necrosis if not well irrigated, and delayed implant secondary stability, as well as some
      patient-related drawbacks as headache and vertigo.3 Fortunately, in 2014 Salah Huwais
      introduced new burs called densah burs that help preservation of bone health by condensing
      bone rather than removing it. Accordingly, this process was labeled osseodensification. In
      the past few years since the introduction of densah burs, limited number of studies evaluated
      its efficiency as well as patient perception to the procedure. 4 It is well established that
      cone beam computed tomography (CBCT) gives more profound and accurate assessment of pre- and
      post-operative implant sites. However, a meta-analysis was published in 2018 showed that most
      previous studies on lifting procedures used conventional 2D techniques, and very few applied
      CBCT as the diagnostic modality. This heterogeneity highly affected the quality of evidence
      retrieved. 5 This study aimed to validate the clinical complications that might be presented
      with osteotome and densah burs, as well as to assess the new bone generated at 6 months
      post-operatively using CBCT. The study hypothesis was that densah bur would show comparable
      results to osteotome-mediated sinus lifting.
    

Intervention name(s): densah bur
Intervention type(s): Procedure
Intervention description(s): osseodensification densah bur
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: randomized control trail
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Sinus lifting; CBCT