关键词: 经牙槽嵴上颌窦底内提升术, 骨致密化技术, 种植体稳定性, 骨凿法

Abstract:

Objective To compare the clinical outcomes of osseodensification (OD) and osteotome (OT) techniques in transalveolar sinus floor elevation (TSFE) with simultaneous implant placement. Methods This study enrolled 60 patients (69 implants) undergoing TSFE with simultaneous implantation at Hefei Stomatological Hospital (February 2021 to February 2024). Their residual bone height (RBH) was 4-7 mm. Participants were randomly assigned to the OD group (reverse-rotation drilling for sinus elevation, n=30) or OT group (osteotome mallet technique, n=30). Outcome measurements included intraoperative sinus membrane perforation, implant survival rate, insertion torque (IT), endo-sinus bone gain (ESBG) at baseline and 6 months, and postoperative pain intensity (VAS scores on days 0, 1, 2, and 7). Statistical analysis was performed using SPSS 26.0 with t-tests or Mann-Whitney U tests (α=0.05). Results The sinus membrane perforation rates in the OD group and OT group were 2.78% and 6.06%, respectively. The IT values were (33.33±4.79) N·cm and (29.39±6.47) N·cm, with the OD group showing a significantly higher value than the OT group (P<0.05). On the 0th day after surgery, the VAS score of the OD group was significantly lower than that of the OT group (P<0.05); however, there were no statistically significant differences in VAS scores between the two groups on the 1st, 2nd, and 7th days after surgery (P>0.05). The immediate post-operative ESBG values of the OD group and OT group were (5.01±0.65) mm and (5.02±0.74) mm, respectively, and the ESBG values at 6 months post-operatively were (4.65±0.57) mm and (4.60±0.74) mm, respectively. No statistically significant differences in ESBG were observed between the two groups. At 6 months after surgery, only one implant in OT group fell off, resulting in implant survival rates of 100% (OD group) vs. 96.97% (OT group), with no statistically significant difference (P>0.05). Conclusion While both techniques achieved comparable endo-sinus bone augmentation, OD provided superior primary implant stability and reduced immediate postoperative pain, demonstrating clinical advantages over conventional osteotome methods in TSFE with simultaneous implantation.

Key words: transalveolar sinus floor elevation(TSFE), osseodensification technique, implant stability, osteotome technique