Using Chin Bone Rings for Sinus Lifting and Dental Implants in One Surgery (BRT-SINUS)

Damascus University

Status: Not yet enrolling

Conditions: Severe Alveolar Bone Atrophy of the Posterior Maxilla With Residual Bone Height ≤4 mm

Treatments: Procedure: Bone Ring Technique (BRT)

Study type: Interventional

Funder types: Other

Identifiers

NCT07619846

DN-28102025-542 (Other Identifier)

UDDS-2026-OralMaxillofacial-01

Details and patient eligibility

About

This study evaluates the Bone Ring Technique, a single stage procedure that combines external sinus floor elevation and dental implant placement using an autogenous bone ring harvested from the chin. Ten patients with residual alveolar bone height ≤4 mm in the posterior maxilla will be enrolled. Implant stability (ISQ), vertical bone gain, peri implant bone density, and implant survival will be assessed over 6 months. The aim is to reduce treatment time and surgical interventions compared to traditional two stage approaches.

Full description

The Bone Ring Technique (BRT) was introduced by Giesenhagen (2004) to address severe posterior maxillary atrophy. In this prospective single arm case series, after obtaining ethics approval (DN 28102025 542, Damascus University), ten patients with residual bone height ≤4 mm will undergo: harvesting of an 8 mm cylindrical autogenous bone ring from the mandibular symphysis using trephine burs; creation of a lateral window in the maxillary sinus using a straight handpiece with a diamond round bur; meticulous elevation of the Schneiderian membrane; placement of the bone ring; simultaneous insertion of a dental implant (ICX) through the ring into the native ridge; filling of the defect with xenograft (bovine) particles; coverage with a collagen membrane; and suturing Primary stability will be measured immediately after implantation using resonance frequency analysis (Mega ISQ II).

CBCT scans (PaX i3D, VATECH) will be performed preoperatively, at 1 week, and at 6 months to quantify vertical bone gain (distance from implant shoulder to sinus floor) and peri implant bone density (Hounsfield like units).

Clinical follow up includes suture removal at 7 10 days and assessment of implant survival/success at 6 months (absence of mobility, pain, radiolucency, suppuration, crestal bone loss <1.5 mm).

Results will be submitted for publication in a peer reviewed journal.

Enrollment: 10 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Need for dental implant in posterior maxilla (premolar/molar).
• Residual alveolar bone height ≤4 mm on preoperative CBCT.
• Age ≥18 years.
• Controlled systemic health.
• Able to comply with procedures and follow up.
• Good oral hygiene.
• Signed written informed consent.

Exclusion criteria

• Uncontrolled systemic disease.
• Head/neck radiotherapy.
• Bisphosphonate therapy >3 years.
• Autoimmune disease affecting healing.
• Pregnancy/lactation.
• Active maxillary sinus pathology (sinusitis, cysts, polyps, tumours).
• Heavy smoking (>10 cigarettes/day).
• Severe bruxism.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

10 participants in 1 patient group

Bone Ring Technique (BRT)

Experimental group

Description:

Eligible patients with posterior maxillary atrophy (RBH ≤4 mm) will undergo a single surgical session. Preoperatively, CBCT will be performed. Under local anesthesia, the surgeon will harvest an autogenous bone ring from the chin (mandibular symphysis) using trephine burs. A lateral window will be created in the maxillary sinus wall using a straight handpiece with a diamond round bur. The sinus membrane will be elevated, and the bone ring will be placed into the sinus. A dental implant (ICX) will be inserted through the ring into the residual ridge. The defect will be filled with xenograft particles and covered with a collagen membrane. Sutures will be removed at 7-10 days. Patients will be followed for 6 months with clinical and CBCT evaluations.

Treatment:

Procedure: Bone Ring Technique (BRT)