Conventional versus endoscopic-assisted crestal sinus lifting with simultaneous implant placement: a comparative clinical study

TL;DR

This study compares two sinus lifting techniques and finds that endoscopic-assisted methods reduce membrane perforation but take longer.

Contribution

The study introduces endoscopic-assisted crestal sinus lifting as a novel technique to improve surgical precision and safety.

Findings

Endoscopic-assisted techniques reduced membrane perforation rates compared to conventional methods.

Endoscopic-assisted procedures took significantly longer than conventional ones.

Bone density increased significantly six months after surgery in both groups.

Abstract

Twenty patients with residual bone heights of 4–7 mm in the posterior maxilla were randomly divided into two groups: Group 1 (conventional crestal approach) and Group 2 (endoscopic-assisted crestal approach). A 2.7 mm rigid endoscope was used to monitor membrane integrity after each surgical step. Bone grafting with a xenograft-platelet-rich fibrin mix was performed, followed by implant placement. Membrane perforation rates, surgical time, and bone density changes were evaluated.

Twenty-two implants were placed (11 in each group). Membrane perforation occurred in 33% of cases in Group 1 and 10% in Group 2 (p = 0.582). Group 2 had significantly longer surgical times (27.3 ± 2.00 min) compared to Group 1 (15.4 ± 2.22 min, p < 0.0001). Bone density increased significantly from 609.55 ± 108.71 HU postoperatively to 878.38 ± 114.60 HU at six months (p < 0.001). Endoscopic-assisted techniques significantly reduced perforation rates and improved surgical precision.

The endoscopic-assisted crestal sinus lifting is a unique technique allowing visualization and assessment of membrane integrity and may enhance the safety and the predictability during membrane elevation, reducing complications such as membrane perforation. However, its benefits must be weighed against increased surgical time and cost.

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