Clinical and radiological outcomes of osseodensification and crestal approach sinus kit for transcrestal sinus elevation - A randomized clinical trial.

Background: The aim of the present study was to evaluate the clinical and radiological effectiveness of transcrestal sinus elevation and simultaneous implant placement using osseodensification (OD) and crestal approach sinus (CAS) instruments.

Materials and methods: This randomized controlled double-blinded clinical trial included 20 participants with edentulous spaces requiring 20 implants having residual bone height >5 mm in the posterior maxilla. Participants were randomly allocated into the CAS group and OD group. Indirect sinus elevation with simultaneous implant placement was performed in both groups. Implant stability (IS) was evaluated at baseline and 3 months. Crestal bone loss (CBL) was measured at 3, 6, and 12 months. Apical bone gain (ABG) was measured at 6 and 12 months. Surgical time and patient comfort using the Visual Analog Scale were assessed during the surgery. Unpaired t-test, ANOVA, and Friedman tests were used for inter- and intragroup comparisons. P ≤ 0.05 was deemed statistically significant.

Results: Sinus elevation and simultaneous implant placement showed good clinical and radiological outcomes in both groups. Intergroup comparison showed a significantly greater primary and secondary IS (P = 0.005, 0.008) in the OD group. CBL was less in the OD group (P = 0.02 and 0.03 on mesial and distal sides) than in the CAS group at 6 months of evaluation. ABG was higher in the OD group (4.164 ± 0.293) than the CAS group (2.819 ± 0.415). The average surgical time taken was greater (87.00 ± 15.49 min) in the CAS group than in the OD group (69.00 ± 20.24 min).

Conclusion: Both CAS and OD groups showed significant improvement in all parameters. OD group showed greater benefits in terms of enhanced primary stability, less CBL, enhanced ABG, and lesser surgical time compared to the CAS group.