A CONSORT-Compliant Randomized Comparative Trial of Osseodensification Versus Osteotome Technique for Transcrestal Sinus Elevation with Simultaneous Implant Placement.

Abstract

Purpose: Transcrestal sinus lifting with simultaneous implant placement is a common approach in cases with reduced posterior maxillary bone height. This study aimed to compare the outcomes of osseodensification and osteotomy in transcrestal sinus lift with simultaneous implant placement in patients with limited posterior maxillary bone height.

Materials and methods: This prospective, randomized clinical trial included 28 patients with 42 implants, divided into two groups: osseodensification (n=22) and osteotomy (n=20). The primary outcome was implant stability, measured by insertion torque and ISQ. The mean ISQ values were 67.50 ± 10.89 for Group 1 and 75.09 ± 7.87 for Group 2, a difference that was also statistically significant. Secondary outcomes included marginal bone loss, implant survival, postoperative pain (VAS), analgesic consumption, and oral health-related quality of life (OHIP). Statistical analyses included t-tests, Mann-Whitney U tests, chi-square tests, linear mixed-effects models, and Brunner-Langer models.

Results: Primary stability was significantly higher in the osseodensification group (ISQ: 75.09 ± 7.87 vs. 67.50 ± 10.89; p = 0.013; mean difference: 7.59, 95% CI: 1.68-13.50) and (Torque: 32.95 ± 6.67 vs. 26.25 ± 9.98; p = 0.008; mean difference: 6.70, 95% CI: 1.87-11.53). Both groups had a 100% implant survival rate. Marginal bone loss was comparable (p = 0.459). Analgesic consumption was significantly lower in the osseodensification group (mean difference: -1.36, 95% CI: -2.44 to -0.28; p = 0.016). OHIP scores were significantly lower after prosthetic loading in the osseodensification group (p = 0.008).

Conclusion: Osseodensification yielded greater primary stability and improved patient-reported outcomes compared to osteotomy, with similar implant survival and bone loss.