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

Purpose: There is a paucity of studies that evaluate the treatment outcomes of transcrestal sinus elevation performed without using osteotomes. This study aims to evaluate the 4-year survival of short dental implants placed following transcrestal sinus elevation performed with a frontal cutting drill and to measure the marginal bone stability. Materials and Methods: Transcrestal sinus elevation was performed by sequential bone drilling using a frontal cutting drill. Short (≤ 8.5 mm) dental implants were placed. The patients' demographic data were described. Implant details, survival, marginal bone loss, and complications were analyzed. The implant survival rate was calculated using the Kaplan-Meier method. Results: Fifty-eight implants were placed in 38 patients with a mean age of 56 ± 7 years. The residual bone height was 4.6 ± 1.2 mm and bone grafting was performed for 15 implants. The mean follow-up time was 47 ± 12 months and 41 ± 9 months after insertion and loading, respectively. The implant survival rate was 96.6%, due to 2 implant failures. Cox regression analysis failed to indicate that implant length had a significant effect on the survival rate. Mesial and distal bone loss amounts were 0.9 ± 1 mm and 1.1 ± 1.0 mm, respectively. Conclusion: The use of bone drills alone to perform transalveolar sinus floor elevation is not a risk factor for implant survival and marginal bone stability. A combination of short implants and transcrestal sinus elevation can be effective in the treatment of posterior maxillae with a mean residual bone height 5 mm. Keywords: alveolar bone atrophy, implant survival, marginal bone loss, short implants, sinus floor augmentation