Transcrestal maxillary sinus floor elevation with injectable xenogeneic bone substitute in gel form: A clinical, radiological and histological analysis.

Purpose: This retrospective study measured the increase in bone tissue using the transcrestal maxillary sinus floor elevation with injectable xenogeneic bone substitute in gel form with simultaneous implant placement. This procedure allows elevation of the sinus floor atraumatically, reducing the risk of perforation of the Schneiderian membrane.

Methods: 52 subjects needing unilateral sinus floor elevation, with a residual crestal height from 2 mm to 5 mm, and a request for at least one implant-prosthetic rehabilitation in the posterior maxillary area were enrolled. Transcrestal maxillary sinus floor elevation was performed with injectable xenogeneic bone substitute in gel form. The sinus elevation was measured after the surgery and 6 months later with a CBCT. Average values were calculated for each measure.

Results: 46 implants were simultaneously placed; six implants were placed after 4 months because of the lack of primary stability. All the placed implants, with a follow-up varying from 3 to 5 years after loading, osseointegrated successfully resulting in a survival rate of 100%. Average pre-operative bone height was 4.2 mm while after the surgery the average value reached was 10.1 mm with an average value of new bone gain of 6.43 mm. Histological analysis revealed the presence of 33.2% of vital bone.

Clinical significance: Transcrestal sinus floor elevation with injectable xenogenic bone substitute in gel form is a minimally invasive technique that can reduce the incidence of Schneider membrane perforations, making a widely used method, such as sinus floor elevation, safer and less operator dependent.