Crestal Sinus Lifting Using Densah Burs Versus Lateral Window Technique at Residual Alveolar Ridge Height 3-5 mm With Simultaneous Implant Placement

NCT ID: NCT07329179

Last Updated: 2026-01-09

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 14 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-02-05
• Study Completion Date: 2025-07-20

Brief Summary

The aim of the study was to assess the clinical and radiographic outcomes of crestal sinus lifting using densah burs versus lateral window technique in vertically deficient posterior maxilla with simultaneous implant placement.

Conditions

Sinus Pneumatization

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

crestal technique using densah burs

Seven implant sites underwent sinus membrane elevation procedure using densah burs with crestal approach. Crestal flap was made and Densah bur with diameter 2.00 mm will be used in osseodensification mode with copious irrigation till sinus floor, then diameter 3.00 mm bur up to 3 mm past the sinus floor, then sequential wider burs to reach the final desired width followed by bone grafting and simultaneous implant placement.

Group Type: EXPERIMENTAL

crestal sinus lifting using densah burs

Intervention Type: PROCEDURE

• Crestal flap was made.
• 2 mm densah bur was used first as a pilot drill in clockwise direction and stopped 1 mm before sinus floor. Implant surgical motor setting was changed to reverse.
• The next wider densah bur (3.00 mm) was used and advanced into the previous created osteotomy. When feeling the haptic feedback of the bur reaching the dense sinus floor, pressure was modulated with a pumping motion to advance past the sinus floor in 1 mm increments, up to 3 mm.
• The sequential wider densah burs were used in densifing mode with copious irrigation with pumping motion to achieve additional width with maximum membrane lift of 3 mm to reach final desired width for implant placement.
• The osteotomy was filled with a well hydrated, xenograft. The last densah bur was used in densifing mode with low speed 150-200 rpm with no irrigation.
• The implant was placed into the osteotomy.

lateral window technique

Seven implant sites underwent sinus membrane elevation procedure using lateral window technique. Pyramidal flap was made and an trap door is created in the lateral sinus wall to gain access to Schneiderian membrane in order to elevate it and provide space for the bone graft material to be placed followed by simultaneous implant placement.

Group Type: ACTIVE_COMPARATOR

sinus lifting using lateral window technique

Intervention Type: PROCEDURE

• Trapezoidal flap was made and full thickness mucoperiosteal flap was raised to visualize the lateral side of the maxilla. (Fig. 23)
• Complete osteotomy of lateral window was made to gain access to the Schneiderian membrane using piezosurgery unit to minimize the probability of membrane perforation with round tip (SL3).
• Sinus membrane elevators were used carefully to free up sinus membrane in all directions (mesially, distally and medially).
• The membrane at the inferior aspect of the osteotomy was dissected from the floor of the maxillary sinus and elevated upward to create a space in the floor of the sinus for the bone graft material.
• Drilling of the implant was done using surgical implant kit while using periosteal elevators to protect schniderian membrane.
• Bone graft was packed under the membrane in all directions with the help of pluggers till reach the medial wall of the maxillary sinus.
• Implant was placed and the lateral osteotomy was covered with collagen membrane

Interventions

crestal sinus lifting using densah burs

• Crestal flap was made.
• 2 mm densah bur was used first as a pilot drill in clockwise direction and stopped 1 mm before sinus floor. Implant surgical motor setting was changed to reverse.
• The next wider densah bur (3.00 mm) was used and advanced into the previous created osteotomy. When feeling the haptic feedback of the bur reaching the dense sinus floor, pressure was modulated with a pumping motion to advance past the sinus floor in 1 mm increments, up to 3 mm.
• The sequential wider densah burs were used in densifing mode with copious irrigation with pumping motion to achieve additional width with maximum membrane lift of 3 mm to reach final desired width for implant placement.
• The osteotomy was filled with a well hydrated, xenograft. The last densah bur was used in densifing mode with low speed 150-200 rpm with no irrigation.
• The implant was placed into the osteotomy.

Intervention Type: PROCEDURE

sinus lifting using lateral window technique

• Trapezoidal flap was made and full thickness mucoperiosteal flap was raised to visualize the lateral side of the maxilla. (Fig. 23)
• Complete osteotomy of lateral window was made to gain access to the Schneiderian membrane using piezosurgery unit to minimize the probability of membrane perforation with round tip (SL3).
• Sinus membrane elevators were used carefully to free up sinus membrane in all directions (mesially, distally and medially).
• The membrane at the inferior aspect of the osteotomy was dissected from the floor of the maxillary sinus and elevated upward to create a space in the floor of the sinus for the bone graft material.
• Drilling of the implant was done using surgical implant kit while using periosteal elevators to protect schniderian membrane.
• Bone graft was packed under the membrane in all directions with the help of pluggers till reach the medial wall of the maxillary sinus.
• Implant was placed and the lateral osteotomy was covered with collagen membrane

Intervention Type: PROCEDURE

Other Intervention Names

lateral sinus lifting

Eligibility Criteria

Inclusion Criteria

• 1. Patient medically free from systemic, immunologic or debilitating diseases or local conditions that could affect normal bone healing and/or implant placement.

2. Patient with good oral hygiene. 3. Age from 18 to 55 years. 4. Partially edentulous patients with missed one or more of maxillary posterior teeth with residual alveolar ridge height 3-5 mm and a minimal width of the alveolar ridge 7 mm in the region of the planned implant site.

5. Patients' edentulous ridges covered with optimal width of keratinized mucosa (<3 mm) with no signs of inflammation, ulceration of scar tissue.

6. No history of parafunctional habits. 7. Patients were ready to comply with the follow-up and maintenance program. 8. Sufficient inter arch space for prothesis.

Exclusion Criteria

• 1. Patients with clinical or radiographic evidence of rhinosinusitis or any other pathology in the maxillary sinus.

2. Smokers. 3. Pregnancy.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Mansoura University

OTHER

Sponsor Role: collaborator

Delta University for Science and Technology

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Wael Mohamed Ahmed, professor

Role: STUDY_DIRECTOR

department of oral and maxillofacial surgery, faculty of dentistry, mansoura university

Locations

Faculty of Dentistry, Mansoura University

Al Mansurah, Dakahlia Governorate, Egypt

Countries

Egypt

Other Identifiers

A02061222

Identifier Type: -

Identifier Source: org_study_id