Minimally invasive advantage? Patient feedback supports osseodensification in sinus lift surgery

Abstract

A Commentary on

Gaspar J, Botelho J, Proença L et al.

Osseodensification versus lateral window technique for sinus floor elevation with simultaneous implant placement: a randomized clinical trial on patient-reported outcome measures. Clin Implant Dent Relat Res 2024; 26: 113–126.

Study design

A randomized, controlled, parallel-arm clinical trial.

Objective

To compare patient-reported and surgical outcomes between osseodensification (OD) and lateral window (LW) techniques for sinus floor elevation (SFE) with concurrent implant placement.

Patients and methods

The study received approval from the local Ethics Committee, followed the Helsinki Declaration and CONSORT guidelines, and obtained written informed consent from all participants. Eligibility criteria included adults aged 18 or older, in good systemic health, with a missing posterior maxillary tooth, residual bone height (RBH) ≤ 4 mm, and crestal bone width >6 mm. Patients were randomly assigned to either the OD group or the LW group. Both techniques involved simultaneous single implant placement, and all surgical and prosthetic procedures were performed by one experienced clinician. Primary outcomes were pain (measured on a visual analogue scale), and quality of life (QoL) using a modified Oral Health Impact Profile-14 (OHIP-14) questionnaire, assessed daily for the first week postoperatively. Patients also self-reported symptoms like edema, hematoma, and epistaxis using a 5-point Likert scale. Secondary outcomes included implant stability (ISQ), surgery duration, complications, and analgesic use. Follow up extended for 1 year.

Results

A total of 20 participants (8 males, 12 females; mean age 47.9 years) were included in the study. Up to Day 3, pain levels were significantly lower (p < 0.05) in OD group, which also had a significantly reduced average analgesic intake throughout the first postoperative week (p < 0.001) compared to LW group. The OHIP-14 total scores were significantly lower in OD group on all days except Day 5 (p < 0.05). The mean surgical time was significantly shorter in the OD group (33 vs. 71 min; p < 0.001). Additionally, postoperative symptoms and complications were significantly fewer (p < 0.001), and the ISQ at 6 months was higher in the OD group (p < 0.05). All implants were restored using screw-retained zirconia crowns, with a 100% success rate.

Conclusion

Both OD and LW techniques were effective for SFE with simultaneous implant placement in cases with RBH ≤ 4 mm. However, OD showed superior short-term outcomes, including less pain and swelling, faster surgery, lower analgesic use, and improved QoL measures.