implant placement in the posterior maxilla is problematic, not only due to inferior properties of bone but also due to loss of vertical bone height which happens after extraction of posterior teeth. when the required additional height is few millimeters, indirect transcresta sinus lifting procedures are recommended. This study compares sinus lifting using the conventional osteotome versus the osseodensification with densah burs.
a total of 12 patients with missing maxillary premolars or molars and with limited vertical bone height below the maxillary sinus floor will receive implants either with osteotome or with Densah burs transcrestal sinus lifting to compare clinically and radiographically transcrestal sinus lifting with Densah burs and osteotome with simultaneous implant placement
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
application of first densah bur with densifying mood (reverse) counterclockwise, 1200 revolution per minute until the sinus is reached then use a wider densah bur with the same mode and bouncing motion to elevate the sinus floor up to 3 mm in 1mm increments.
drilling implant site with consecutive drills short of the sinus floor by 1-2mm , using osteotome in appropriate size and application of one tap until sinus floor is elevated, using the final drill for the desired implant diameter
Outpatient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University
Alexandria, Egypt
RECRUITINGimplant stability
Using the Osstell, The result is presented as an ISQ value of 1-100. The higher the ISQ, the more stable the implant
Time frame: at 6 months
change in bone height
using CBCT
Time frame: at baseline and 6 months
change in bone density
using CBCT
Time frame: at baseline and 6 months
Pain scores
10-point Visual Analogue Scale (VAS). (0-1= None, 2-4= Mild, 5-7= Moderate, 8-10= Severe)
Time frame: at 2 weeks
edema scores
The pitting is graded on a scale of +1 to +4 as follows: * +1 (trace) slight indentation rapid return to normal. * +2 (mild) the indentation returns to normal in a few seconds. * +3 (moderate) 6 mm indentation rebounds in 10-20 seconds. * +4 (severe) 8 mm indentation rebounds in more than 30 seconds.
Time frame: at 2 weeks
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