Primary Stability of Implant in Closed Sinus Lifting Cases Using Densah Bur Versus Osteotome

Cairo University (CU)

Status: Unknown

Conditions: Sinus Pneumatization

Treatments: Other: closed sinus lifting by Densah bur; Other: closed sinus lifting by Osteotome

Study type: Interventional

Funder types: Other

Identifiers

NCT03559777

closed sinus lifiting

Details and patient eligibility

About

This study is aiming to evaluate primary stability of implant in closed sinus lifting cases by Densah bur in compared to Osteotome in partially edentulous patients hoping that densah bur can lift the sinus membrane and improve primary stability of implant.

Full description

The osteotome technique is effective in certain cases, but the most sensitive aspect is the tapping force, which should be sufficient enough to infracture the sinus floor cortical bone but restrained enough to prevent the osteotome tip from traumatizing the Schneiderian membrane.

Several surgical techniques have been proposed to minimize the sinus membrane perforation rate by using a piezosurgical device, balloon, hydrostatic pressure.

The success of therapy in posterior maxilla is not only dependent on the success of the sinus elevation but also the primary stability of the implant that allow bone apposition on the implant surface without any micromovement for osseeointegration.

Later, densah burs are introduced as another treatment option for internal transalveolar approach of sinus floor elevation with improving primary stability of implant by osseodensification.

As treatment options of edentulous maxillary today may include dental implants, the practitioner must be familiar with various sinus lift surgical techniques in order to choose an ideal treatment option for the patient.

Enrollment: 14 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Both males as well as females without any active periodontal disease.
• All patients were in a good health with no systemic diseases.
• All selected patients were non-smokers and non-alcoholics.
• Patient were free from T.M.J troubles, abnormal oral habits such as bruxism.
• The edentulous ridges were covered with optimal thickness of soft tissue.
• Remaining natural teeth had good.
• Periodontal tissue support and occlusion showed sufficient inter arch space.
• On the local level, patients with maxillary sinus diseases and unfavorable inter maxillary relationship were excluded.

Exclusion criteria

• Patients with residual bone height less than 6mm.
• Patients with systemic disease that may affect bone quality.
• Patients with poor oral hygiene and active periodontal diseases.
• Patient with limited mouth opening.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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14 participants in 2 patient groups

closed sinus lifting by Osteotome

Active Comparator group

Description:

* Local anesthesia will be injected intra-orally * A full thickness flap will be elevated * A pilot drill will be used to start the osteotomy preparation, which should be ended 1mm short of sinus floor. * The widening drills can be sequentially used to widen the osteotomy site to the same level * An osteotome of diameter a little less than the planned implant body, will be inserted in the prepared osteotomy site and gently tapped to reach the same level. * The osteotome will be tapped gently to fracture up the sinus floor. * Xenograft will be added to the osteotomy as the grafting material. * Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted. * Smart peg will be placed on implant and Ostell will be used to record ISQ. * Healing collar will be placed on implant. * Suturing the flab around healing collar.

Treatment:

Other: closed sinus lifting by Osteotome

closed sinus lifting by Densah bur

Experimental group

Description:

* Local anesthesia will be injected intra-orally * A full thickness flap will be elevated * A pilot drill will be used to start the osteotomy , which should be ended 1mm short of sinus floor. * Change the drill motor to reverse- densifying Mode * Begin with the densah bur (2.5mm) until 1 mm short of the sinus floor. * Use the next wider Densah Bur (3.0) in densifying-mode until feeling the haptic feedback of the bur reaching the dense sinus floor, modulate pressure with a gentle pumping motion to advance past the sinus floor in 1 mm increments. * densah burs (3.5mm) advance in the osteotomy. * Xenograft will be added to the osteotomy . * Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted. * Smart peg will be placed on implant and Ostell will be used to record ISQ. * Healing collar will be placed on implant. * Suturing the flab around healing collar.

Treatment:

Other: closed sinus lifting by Densah bur