Osseodensification by Densah burs in combination with activated plasma albumin gel for transcrestal maxillary sinus lifting with simultaneous implant placement.

Abstract

Purpose: This study aimed to assess the clinical and radiographic outcomes of transcrestal maxillary sinus lifting using Densah burs in combination with activated plasma albumin gel (APAG) during simultaneous implant placement in cases with severely limited residual bone height (3-5 mm).

Methods: A total of six patients with missing posterior maxillary teeth and insufficient alveolar bone height were treated using the osseodensification technique with Densah burs and APAG. CBCT scans were obtained preoperatively and six months postoperatively to evaluate changes in bone height and peri-implant bone density. Bone density was estimated using CBCT gray values derived from OnDemand 3D software, recognizing that these values provide relative rather than absolute measurements and are subject to inherent limitations.

Results: No post-operative complications were recorded, and the sinus membrane remained intact in all cases. After six months, a statistically significant bone height gain was observed (mean 5.28 ± 0.70 mm; p < 0.001), along with a significant increase in bone density (mean difference 255.15 ± 95.69 HU; p < 0.001). Implant stability showed no statistically significant difference between primary and secondary ISQ values (mean difference 1.17 ± 4.31; p = 0.54).

Conclusion: The combined use of Densah burs and activated plasma albumin gel for transcrestal sinus lifting appears to be a safe and minimally invasive technique, promoting substantial bone height gain and improved peri-implant bone density. The bioactive plasma gel played a key role in effective sinus membrane elevation and vertical bone augmentation.

Trial registration number: This trial was retrospectively registered on ClinicalTrials.gov (ID: NCT06360263) in July 2023.