Comparison of clinical and radiological outcomes using crestal approach sinus kit and piezoelectric surgery for sinus membrane elevation: A prospective clinical trial

Aishwarya Ratna Mamidi, Sruthima N. V. S. Gottumukkala, Satyanarayana Raju Mantena, Gautami S. Penmetsa, Konathala S. V. Ramesh, Mohan Kumar Pasupuleti


Background: To overcome the drawbacks of sinus floor augmentation procedures newer surgical
techniques to reduce sinus perforation such as crestal approach sinus kit (CAS) and piezosurgery,
which are minimally invasive procedures enabling uncomplicated sinus elevation have evolved. The
aim of the present study was to investigate the performance of CAS kit compared to piezosurgery
during maxillary sinus membrane elevation.
Materials and Methods: A total of 40 subjects requiring maxillary sinus membrane augmentation
for rehabilitation with implant prosthesis in posterior maxilla were included in the study. The current
study was a prospective clinical trial where osteotomy and sinus elevation was done using CAS
kit in Group 1 and piezosurgery in Group 2. Platelet‑rich fibrin was placed in osteotomy site and
dental implants were inserted. Implant stability was evaluated at baseline and 3 months. Crestal
bone loss was measured at 3, 6, and 12 months. Apical bone gain was measured at 6 and 12 months.
Intragroup comparison of the study groups was done by Paired t‑test, ANOVA test, and Friedman
test. Intergroup comparison was done by unpaired t‑test and Mann–Whitney U‑test. P < 0.05 was
considered statistically significant.
Results: Implant stability improved in both the groups, i.e., 79.2 ± 5.02 and 79 ± 5.31 in
Group 1 and Group 2, respectively, at 3 months. Intergroup comparison showed no difference
in all parameters; however, crestal bone loss was greater in piezosurgery group with a mean
difference of 0.74 mm.
Conclusion: Both CAS and piezosurgery groups showed definitive improvement in all parameters.
CAS group resulted in added benefits in terms of less crestal bone loss and intraoperative surgical
time compared to piezosurgery group.
Key Words: Dental implants, minimally invasive surgical procedures, piezosurgery, platelet‑rich
fibrin, sinus floor augmentation

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