Abstract
Purpose: Various maxillary sinus floor elevation techniques are used together with augmentation procedures
for oral rehabilitation. Dental implants with or without bone substitutes or autologous bone grafting, and applied
using the lateral window technique or the transcrestal osteotome-mediated sinus floor elevation technique, are
used to enhance bone stability for implant installation. The aim of this study was to retrospectively evaluate the
implant status of patients who had undergone maxillary sinus floor elevation and immediate or delayed implant
placement via such techniques, with or without graft materials.
Materials and Methods: In total, 398 dental implants placed in 169 maxillary sinuses of 169 patients (106 females,
63 males; mean age, 57.5 years), who were fitted with Astra Tech dental implants, and required maxillary sinus
floor elevation, were evaluated in terms of the amount of residual bone remaining following treatment; the residual
bone was assessed by elevation technique subgroup. The vertical height of the residual maxillary alveolar
bone and the augmented vertical bone height were analyzed using digitalized panoramic radiographs. Clinical
and radiological follow-up was carried out over a period of 120 months after functional loading of a fixed prosthesis.
The mean follow-up period was 55 months.
Results: In total, 277 implants, with a mean residual vertical bone height of 3.72 mm, were installed in 113 maxillary
sinuses using the lateral window technique. Of these, 216 implants (mean vertical bone height, 4.87 mm)
were installed in 96 sinuses simultaneous with sinus floor elevation using β-tricalcium phosphate (βTCP) using no
graft material or intraoral autologous bone. The remaining 17 sinuses underwent 61 implants (mean vertical bone
height, 2.57 mm) according to a delayed installation schedule using βTCP or iliac autologous bone. In 56 sinuses,
121 implants (mean vertical height, 8.60 mm) were installed simultaneous via the transcrestal osteotome-mediated
technique with βTCP. Although seven implants failed (three early and four late failures) over a follow-up period
of 120 months (mean follow-up, 55 months), the other implants remained stable, with a high survival rate of 98.2%.
No elevation technique or graft material subgroup showed any statistical significance, and complications were
minimal.
Conclusions: The findings of this study demonstrate that various maxillary sinus floor elevation techniques for
implant installation, with or without graft material, are safe, having low complication rates and yielding predictable
results.
