Radiographic Techniques for Dental Implants

Overseen By Charles Powell, DDS, MS

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: The University of Texas Health Science Center at San Antonio

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

A closed sinus augmentation is performed for dental implant placement.

Do I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you use medications that affect bone metabolism.

What data supports the idea that Radiographic Techniques for Dental Implants is an effective treatment?

The available research shows that Radiographic Techniques for Dental Implants, like the transcrestal sinus lift, are effective. One study followed patients for 1 year and found that immediate implant placement with this technique offers many benefits. Another study with a 5-year follow-up confirmed that these procedures are well established. A different study looked at the survival of implants over 4 years and found that the technique helps maintain bone stability. Additionally, an 8-year study involving 1,100 patients showed that a minimally invasive approach effectively addresses challenges in implant placement. These studies suggest that this treatment is reliable and beneficial for patients. ^{1 2 3 4 5}

What safety data exists for transcrestal sinus floor elevation in dental implants?

The safety data for transcrestal sinus floor elevation, also known as Closed Sinus Augmentation, Internal Sinus Lift, Transcrestal Sinus Augmentation, or Crestal Sinus Lift, includes several findings: 1) The Smart Lift technique showed no complications during or after surgery, with stable implant results up to 1 year. 2) Patient-reported outcomes suggest that transcrestal sinus floor elevation does not increase morbidity compared to implant placement in native bone. 3) A pilot study found that sinus membrane perforation is a potential risk, but techniques and materials, such as the pedicled buccal fat pad graft, can effectively repair perforations. 4) Grafted bone remodeling is a factor to consider, as it can affect the stability of the grafted bone height. ^{6 7 8 9 10}

Is Closed Sinus Augmentation a promising treatment for dental implants?

Yes, Closed Sinus Augmentation is a promising treatment for dental implants. It is less invasive, saves time, and can be done at the same time as implant placement. This technique helps increase bone height, which is important for the success of dental implants. ^{3 5 11 12 13}

Research Team

Charles Powell, DDS, MS

Principal Investigator

The University of Texas Health Science Center at San Antonio

Eligibility Criteria

This trial is for individuals who require a closed sinus augmentation procedure to prepare for dental implant placement. Specific eligibility criteria are not provided, so it's best to contact the study organizers for detailed requirements.

Inclusion Criteria

Nonsmokers

I need a procedure to prepare for dental implants due to missing some teeth.

I have at least 5mm of bone under my sinus.

Exclusion Criteria

Tobacco use

Alcoholism or recreational drug use

My diabetes is not well-controlled (HbA1C above 7.0).

Treatment Details

Interventions

• Closed Sinus Augmentation (Procedure)

Trial Overview The study is examining changes in the maxillary sinus after a closed sinus lift by comparing images from a 3D R100 scanner with those from conventional radiographs.

Participant Groups

Group I: Low volume CBCT Active Control 1 Intervention

Radiographic low volume cone beam computed tomography used to plan implant placement

Group II: Standard periapical radiographs Placebo Group 1 Intervention

Standard radiography used to plan implant placement

Closed Sinus Augmentation is already approved in Canada for the following indications:

Approved in Canada as Closed Sinus Augmentation for:

• Vertical bone augmentation in the posterior segment of the edentulous maxilla for dental implant placement

Who Is Running the Clinical Trial?

The University of Texas Health Science Center at San Antonio

Lead Sponsor

Trials

486

Recruited

92,500+

Findings from Research

The new internal crestal approach for sinus lift procedures, which uses hydraulic pressure and a specialized bone grafting technique, minimizes the risk of membrane perforation and allows for simultaneous implant placement.

In a retrospective study of 1,100 cases, the method demonstrated a low failure rate of 0.73% for implants and showed effectiveness in patients with limited alveolar ridge heights, making it a reliable option for challenging anatomical conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An 8-year retrospective study: 1,100 patients receiving 1,557 implants using the minimally invasive hydraulic sinus condensing technique. Chen, L., Cha, J.[2014]

The flapless Localised Management of Sinus Floor (LMSF) technique for maxillary sinus elevation and simultaneous dental implant placement showed a high cumulative success rate of 95% across 71 procedures performed on 52 patients, indicating its efficacy.

This technique is safe with minimal postoperative complications and avoids the need for additional grafting, using only native bone for augmentation, which reduces patient morbidity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Flapless Localised Management of Sinus Floor (LMSF) for trans-crestal sinus floor augmentation and simultaneous implant placement. A retrospective non-randomized study: 5-year of follow-up. Bruschi, GB., Bruschi, E., Papetti, L.[2022]

In a study involving 37 patients, immediate implant insertion combined with transcrestal sinus augmentation showed no implant failures, indicating a high safety and efficacy of this technique for maxillary molar replacement.

The study found that the relationship between maxillary molar roots and the sinus floor can influence bone height, but there were no significant differences in marginal bone loss or other clinical parameters among different root-sinus relationships after one year.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcrestal sinus floor augmentation with immediate implant placement applied in three types of fresh extraction sockets: A clinical prospective study with 1-year follow-up. Chen, Y., Yuan, S., Zhou, N., et al.[2018]

The Smart Lift technique for transcrestal sinus floor elevation is a minimally invasive method that effectively uses existing bone to augment the sinus cavity, reducing the risk of complications such as membrane perforation.

In a case study, the Smart Lift procedure demonstrated successful implant stability and no complications for up to 1 year post-surgery, with clear radiographic evidence of bone augmentation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Minimally invasive technique for transcrestal sinus floor elevation: a case report. Trombelli, L., Minenna, P., Franceschetti, G., et al.[2021]

The study found that maxillary sinus floor elevation with a transcrestal approach (tSFE) during implant placement resulted in low postoperative pain and complications, similar to implants placed entirely in native bone, based on data from 31 patients.

Both procedures showed comparable patient-reported outcomes, with no significant differences in pain levels, discomfort, or willingness to undergo the surgery again, indicating that tSFE does not increase the morbidity of implant surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient-reported outcomes of implant placement performed concomitantly with transcrestal sinus floor elevation or entirely in native bone. Franceschetti, G., Rizzi, A., Minenna, L., et al.[2018]

The sinus lift procedure, while generally safe, can lead to complications such as perforation of the sinus membrane, which requires effective repair techniques.

Using a pedicled buccal fat pad for closing large perforations during the sinus lift showed promising results, with no serious infections and satisfactory clinical and radiographic outcomes after one year.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Closure of large perforation of sinus membrane using pedicled buccal fat pad graft: a case report. Kim, YK., Hwang, JW., Yun, PY.[2022]

In a study using 20 human cadaver heads, no significant differences in sinus membrane perforation rates were found among three different transcrestal sinus floor elevation techniques, indicating that the risk of perforation is similar regardless of the method used.

Real-time endoscopy revealed that perforations were more frequently noted during implant placement compared to graft insertion, although this difference was not statistically significant, highlighting the importance of careful monitoring throughout the procedure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study. Garbacea, A., Lozada, JL., Church, CA., et al.[2022]

In a study of 25 implant sites, the use of synthetic biphasic calcium phosphate for transcrestal sinus floor elevation resulted in an average graft height reduction of 0.57 mm after 6-8 months, indicating some degree of remodeling of the grafted bone.

The reduction in graft height was positively correlated with factors such as the vertical amount of implant protrusion and the vertical elevation height, suggesting that these factors may influence the stability of the grafted bone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grafted bone remodeling following transcrestal sinus floor elevation: A cone-beam computed tomography study. Kuo, PY., Lin, CY., Chang, CC., et al.[2021]

The transcrestal sinus lift using the sinus balloon technique resulted in an average bone height gain of 8.7 mm, allowing for successful dental implant placement even with only 3 mm of residual bone.

One year after the procedure, the implant success rate was 100% in the five patients studied, indicating the efficacy and safety of this minimally invasive technique.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcrestal sinus lift and implant placement using the sinus balloon technique. Peñarrocha-Diago, M., Galán-Gil, S., Carrillo-García, C., et al.[2021]

The chapter emphasizes the importance of implant stability, which is heavily influenced by the amount of available bone, particularly in the posterior maxilla where low-lying maxillary sinuses can limit alveolar height.

It reviews traditional methods like the lateral sinus lift and the transcrestal osteotome approach for vertical bone augmentation, along with osseodensification as a potential alternative technique.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Update on Maxillary Sinus Augmentation. Bhalla, N., Dym, H.[2021]

Transalveolar sinus elevation is a less invasive and time-efficient technique for addressing bone height deficiencies in the posterior maxilla, making it a favorable option for dental implant placement.

The review analyzed 26 articles on various modifications of this technique, highlighting that the choice of method should depend on the clinician's expertise, available equipment, and the specific bone conditions of the patient.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Different techniques in transalveolar maxillary sinus elevation: A literature review. Lafzi, A., Atarbashi-Moghadam, F., Amid, R., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Radiographic analysis of a transalveolar sinus-lift technique: a multipractice retrospective study with a mean follow-up of 5 years. [2014]

2. United States pubmed.ncbi.nlm.nih.gov

An 8-year retrospective study: 1,100 patients receiving 1,557 implants using the minimally invasive hydraulic sinus condensing technique. [2014]

3. England pubmed.ncbi.nlm.nih.gov

Flapless Localised Management of Sinus Floor (LMSF) for trans-crestal sinus floor augmentation and simultaneous implant placement. A retrospective non-randomized study: 5-year of follow-up. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Transcrestal Sinus Floor Augmentation by Sequential Drilling and the Use of Plasma Rich in Growth Factors. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Transcrestal sinus floor augmentation with immediate implant placement applied in three types of fresh extraction sockets: A clinical prospective study with 1-year follow-up. [2018]

6. Germany pubmed.ncbi.nlm.nih.gov

Minimally invasive technique for transcrestal sinus floor elevation: a case report. [2021]

7. Denmark pubmed.ncbi.nlm.nih.gov

Patient-reported outcomes of implant placement performed concomitantly with transcrestal sinus floor elevation or entirely in native bone. [2018]

8. United States pubmed.ncbi.nlm.nih.gov

Closure of large perforation of sinus membrane using pedicled buccal fat pad graft: a case report. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Grafted bone remodeling following transcrestal sinus floor elevation: A cone-beam computed tomography study. [2021]

11. Spain pubmed.ncbi.nlm.nih.gov

Transcrestal sinus lift and implant placement using the sinus balloon technique. [2021]

12. United States pubmed.ncbi.nlm.nih.gov

Update on Maxillary Sinus Augmentation. [2021]

13. Iran pubmed.ncbi.nlm.nih.gov

Different techniques in transalveolar maxillary sinus elevation: A literature review. [2022]