Skip to main content
Top
Published in:

Open Access 01-12-2017 | Research

Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study

Authors: Aghiad Yassin Alsabbagh, Mohammed Monzer Alsabbagh, Batol Darjazini Nahas, Salam Rajih

Published in: International Journal of Implant Dentistry | Issue 1/2017

Login to get access

Abstract

Background

Various techniques are available for elevating the sinus membrane. The aim of this study is to evaluate three methods of indirect sinus floor elevation regarding elevation heights of 7 mm on the outcomes of membrane perforation, length of perforation, and time required to perform the procedure.

Methods

Three different methods for indirect sinus lifting, bone added osteotome sinus floor elevation (BAOSFE), sinus floor elevation with an inflatable balloon, and crestal approach system (CAS kit) from OSSTEM, were assessed for their ability to lift the sinus without causing laceration of the Schneiderian membrane. The study was performed on 18 freshly slaughtered sheep heads (36 sinus lifts were done, 12 for each method). CBCT images of the heads were taken to assess the best location for the sinus lift. Then, the heads were bisected and the membrane was exposed from the medial aspect. After that, each method was performed. The intended elevation height was 7 mm. If the 7 mm were not reached, the maximum height of elevation was measured.

Results

The method used was significantly associated with the occurrence of perforation (p value = 0.014) where BAOSFE was associated with the largest number of perforations (58.4%, n = 7) compared to 8.3% and 8.3% for the balloon and CAS kit methods, respectively. The odds ratio for perforation occurrence from BAOSFE compared to the CAS kit was significant (OR = 0.091, p = .022). No significant odds ratio was found for the balloon method compared to CAS kit. Additionally, the method used was significantly associated with time of operation and with the length of perforation (p value < 0.001) where CAS kit required the longest time and BAOSFE caused the biggest perforations.

Conclusions

The study shows that both the balloon and the CAS kit were superior to the BAOSFE in terms of safety in elevating the sinus membrane. Further, in vivo studies have to prove these findings.
Literature
1.
go back to reference Seong WJ, Barczak M, Jung J, Basu S, Olin PS, Conrad HJ. Prevalence of sinus augmentation associated with maxillary posterior implants. The Journal of oral implantology. 2013;39(6):680–8.CrossRefPubMed Seong WJ, Barczak M, Jung J, Basu S, Olin PS, Conrad HJ. Prevalence of sinus augmentation associated with maxillary posterior implants. The Journal of oral implantology. 2013;39(6):680–8.CrossRefPubMed
2.
go back to reference Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232–6.CrossRefPubMed Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232–6.CrossRefPubMed
3.
go back to reference Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique. J Clin Periodontol. 2008;35(8 Suppl):241–54.CrossRefPubMed Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique. J Clin Periodontol. 2008;35(8 Suppl):241–54.CrossRefPubMed
4.
go back to reference Cho SC, Wallace SS, Froum SJ, Tarnow DP. Influence of anatomy on Schneiderian membrane perforations during sinus elevation surgery: three-dimensional analysis. Pract Proced Aesthet Dent. 2001;13(2):160–3.PubMed Cho SC, Wallace SS, Froum SJ, Tarnow DP. Influence of anatomy on Schneiderian membrane perforations during sinus elevation surgery: three-dimensional analysis. Pract Proced Aesthet Dent. 2001;13(2):160–3.PubMed
5.
go back to reference Kim YK, Cho YS, Yun PY. Assessment of dentists’ subjective satisfaction with a newly developed device for maxillary sinus membrane elevation by the crestal approach. Journal of periodontal & implant science. 2013;43(6):308–14.CrossRef Kim YK, Cho YS, Yun PY. Assessment of dentists’ subjective satisfaction with a newly developed device for maxillary sinus membrane elevation by the crestal approach. Journal of periodontal & implant science. 2013;43(6):308–14.CrossRef
6.
go back to reference Soltan M, Smiler DG. Antral membrane balloon elevation. The Journal of oral implantology. 2005;31(2):85–90.CrossRefPubMed Soltan M, Smiler DG. Antral membrane balloon elevation. The Journal of oral implantology. 2005;31(2):85–90.CrossRefPubMed
7.
go back to reference Stelzle F, Benner KU. Evaluation of different methods of indirect sinus floor elevation for elevation heights of 10 mm: an experimental ex vivo study. Clin Implant Dent Relat Res. 2011;13(2):124–33.CrossRefPubMed Stelzle F, Benner KU. Evaluation of different methods of indirect sinus floor elevation for elevation heights of 10 mm: an experimental ex vivo study. Clin Implant Dent Relat Res. 2011;13(2):124–33.CrossRefPubMed
8.
go back to reference Lopez-Nino J, Garcia-Caballero L, Gonzalez-Mosquera A, Seoane-Romero J, Varela-Centelles P, Seoane J. Lamb ex vivo model for training in maxillary sinus floor elevation surgery: a comparative study with human standards. J Periodontol. 2012;83(3):354–61.CrossRefPubMed Lopez-Nino J, Garcia-Caballero L, Gonzalez-Mosquera A, Seoane-Romero J, Varela-Centelles P, Seoane J. Lamb ex vivo model for training in maxillary sinus floor elevation surgery: a comparative study with human standards. J Periodontol. 2012;83(3):354–61.CrossRefPubMed
9.
go back to reference Benavides E, Rios HF, Ganz SD, An C-H, Resnik R, Reardon GT, et al. Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report. Implant Dent. 2012;21(2):78–86.CrossRefPubMed Benavides E, Rios HF, Ganz SD, An C-H, Resnik R, Reardon GT, et al. Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report. Implant Dent. 2012;21(2):78–86.CrossRefPubMed
10.
go back to reference Harris D, Quirynene M. Guidelines for the use of diagnostic imaging in implant dentistry: update of the EAO clinical oral implants research. 2012. Harris D, Quirynene M. Guidelines for the use of diagnostic imaging in implant dentistry: update of the EAO clinical oral implants research. 2012.
12.
go back to reference Younes R, Nader N, Khoury G. Sinus grafting techniques: a step-by-step guide 2015. Younes R, Nader N, Khoury G. Sinus grafting techniques: a step-by-step guide 2015.
13.
go back to reference Hu X, Lin Y, Metzmacher AR, Zhang Y. Sinus membrane lift using a water balloon followed by bone grafting and implant placement: a 28-case report. Int J Prosthodont. 2009;22(3):243–7.PubMed Hu X, Lin Y, Metzmacher AR, Zhang Y. Sinus membrane lift using a water balloon followed by bone grafting and implant placement: a 28-case report. Int J Prosthodont. 2009;22(3):243–7.PubMed
14.
go back to reference Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):8–17.CrossRefPubMed Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):8–17.CrossRefPubMed
15.
go back to reference Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. The Cochrane database of systematic reviews 2014(5):CD008397. Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. The Cochrane database of systematic reviews 2014(5):CD008397.
16.
go back to reference Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol. 2004;75(4):511–6.CrossRefPubMed Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol. 2004;75(4):511–6.CrossRefPubMed
17.
go back to reference Emmerich D, Att W, Stappert C. Sinus floor elevation using osteotomes: a systematic review and meta-analysis. J Periodontol. 2005;76(8):1237–51.CrossRefPubMed Emmerich D, Att W, Stappert C. Sinus floor elevation using osteotomes: a systematic review and meta-analysis. J Periodontol. 2005;76(8):1237–51.CrossRefPubMed
18.
go back to reference Engelke W, Deckwer I. Endoscopically controlled sinus floor augmentation. A preliminary report. Clin Oral Implants Res. 1997;8(6):527–31.CrossRefPubMed Engelke W, Deckwer I. Endoscopically controlled sinus floor augmentation. A preliminary report. Clin Oral Implants Res. 1997;8(6):527–31.CrossRefPubMed
19.
go back to reference Sendyk W, Sendyk C. Reconstrução óssea por meio do levantamento do assoalho do seio maxilar. São Paulo: Santos. 2002:109–22. Sendyk W, Sendyk C. Reconstrução óssea por meio do levantamento do assoalho do seio maxilar. São Paulo: Santos. 2002:109–22.
20.
go back to reference Summers RB. The osteotome technique: part 3—less invasive methods of elevating the sinus floor. Compendium. 1994;15(6):698, 700, 2–4 passim; quiz 10. Summers RB. The osteotome technique: part 3—less invasive methods of elevating the sinus floor. Compendium. 1994;15(6):698, 700, 2–4 passim; quiz 10.
21.
go back to reference Pommer B, Watzek G. Gel-pressure technique for flapless transcrestal maxillary sinus floor elevation: a preliminary cadaveric study of a new surgical technique. Int J Oral Maxillofac Implants. 2009;24(5):817–22.PubMed Pommer B, Watzek G. Gel-pressure technique for flapless transcrestal maxillary sinus floor elevation: a preliminary cadaveric study of a new surgical technique. Int J Oral Maxillofac Implants. 2009;24(5):817–22.PubMed
22.
go back to reference Sotirakis EG, Gonshor A. Elevation of the maxillary sinus floor with hydraulic pressure. The Journal of oral implantology. 2005;31(4):197–204.CrossRefPubMed Sotirakis EG, Gonshor A. Elevation of the maxillary sinus floor with hydraulic pressure. The Journal of oral implantology. 2005;31(4):197–204.CrossRefPubMed
23.
go back to reference Jesch P, Bruckmoser E, Bayerle A, Eder K, Bayerle-Eder M, Watzinger F. A pilot-study of a minimally invasive technique to elevate the sinus floor membrane and place graft for augmentation using high hydraulic pressure: 18-month follow-up of 20 cases. Oral surgery, oral medicine, oral pathology and oral radiology. 2013;116(3):293–300.CrossRefPubMed Jesch P, Bruckmoser E, Bayerle A, Eder K, Bayerle-Eder M, Watzinger F. A pilot-study of a minimally invasive technique to elevate the sinus floor membrane and place graft for augmentation using high hydraulic pressure: 18-month follow-up of 20 cases. Oral surgery, oral medicine, oral pathology and oral radiology. 2013;116(3):293–300.CrossRefPubMed
24.
go back to reference Bae OY, Kim YS, Shin SY, Kim WK, Lee YK, Kim SH. Clinical outcomes of reamer- vs osteotome-mediated sinus floor elevation with simultaneous implant placement: a 2-year retrospective study. Int J Oral Maxillofac Implants. 2015;30(4):925–30.CrossRefPubMed Bae OY, Kim YS, Shin SY, Kim WK, Lee YK, Kim SH. Clinical outcomes of reamer- vs osteotome-mediated sinus floor elevation with simultaneous implant placement: a 2-year retrospective study. Int J Oral Maxillofac Implants. 2015;30(4):925–30.CrossRefPubMed
25.
go back to reference Ahn SH, Park EJ, Kim ES. Reamer-mediated transalveolar sinus floor elevation without osteotome and simultaneous implant placement in the maxillary molar area: clinical outcomes of 391 implants in 380 patients. Clin Oral Implants Res. 2012;23(7):866–72.CrossRefPubMed Ahn SH, Park EJ, Kim ES. Reamer-mediated transalveolar sinus floor elevation without osteotome and simultaneous implant placement in the maxillary molar area: clinical outcomes of 391 implants in 380 patients. Clin Oral Implants Res. 2012;23(7):866–72.CrossRefPubMed
26.
go back to reference Toffler M, Toscano N, Holtzclaw D. Osteotome-mediated sinus floor elevation using only platelet-rich fibrin: an early report on 110 patients. Implant Dent. 2010;19(5):447–56.CrossRefPubMed Toffler M, Toscano N, Holtzclaw D. Osteotome-mediated sinus floor elevation using only platelet-rich fibrin: an early report on 110 patients. Implant Dent. 2010;19(5):447–56.CrossRefPubMed
Metadata
Title
Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study
Authors
Aghiad Yassin Alsabbagh
Mohammed Monzer Alsabbagh
Batol Darjazini Nahas
Salam Rajih
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Implant Dentistry / Issue 1/2017
Electronic ISSN: 2198-4034
DOI
https://doi.org/10.1186/s40729-017-0103-5