Objectives <p>The Schneiderian membrane is elevated to place bone graft material during sinus floor augmentation. Since the teeth’s vascular and neurovascular supply passes through the maxillary sinus, this procedure may lead to sensitivity loss in adjacent teeth. This study is the first to prospectively analyze the vitality of adjacent teeth after sinus floor elevation.</p> Materials and methods <p>Data were collected between 2015 and 2023 from 158 patients, who underwent maxillary sinus floor augmentation and implant placement. A total of 378 teeth were examined for vitality using cold testing at the following time points: (1) before sinus floor elevation, (2) 2 weeks, (3) 4 months, (4) 8 months, and (5) 12 months post-surgery. Follow-up duration ranged from 12 to 32 months.</p> Results <p>Two teeth in two patients showed no vitality before surgery, but became vital postoperatively. In 3 teeth (0.79%), pulp vitality loss was recorded 2 weeks after surgery, which was restored at the 4-month follow-up. These teeth remained vital after one year. The pre-and postoperative pulp vitality comparison showed no statistically significant difference (<i>p</i> = 0.625).</p> Conclusions <p>This first prospective observational study demonstrated that a few patients experienced temporary pulp sensitivity loss immediately post-surgery, which resolved within four months.</p> Clinical relevance <p>Pulp sensitivity loss due to vascular disruption during sinus floor augmentation is rare and usually temporary. Despite potential vascular disruption, sinus floor augmentation procedures do not appear to cause permanent pulp sensitivity loss.</p> Graphical Abstract <p></p>