Effectiveness and influencing factors of strip-cushioning transcrestal sinus floor elevation: a clinical retrospective study
摘要
To evaluate effectiveness of the strip-cushioning TSFE with simultaneous implant placement; and to investigate its potential influencing factors, including anatomical variations. The primary outcome was endo-sinus bone gain (ESBG) before prosthesis.
Materials and methodsThis retrospective study assessed ESBG and crestal bone level (CBL) using cone-beam computed tomography (CBCT) before surgery (T0), immediately after surgery (T1), and before prosthesis (T2), along with peri-apical radiographs at prosthesis (T3) and during post-loading follow-ups (T4 to T6). One-way repeated measures ANOVA assessed bone height changes. Univariate and multivariate generalized linear mixed models (GLMM) identified the factors influencing ESBG and Schneiderian membrane perforation rate.
ResultsA total of 88 patients with 107 implants were included. Bone height under sinus floor significantly increased at five peri-implant positions from T0 to T1 and T2. The mean ESBG was 5.55 mm (T1) and 4.62 mm (T2). GLMM revealed the first molar site (p = 0.036) and RBH < 5 mm (p < 0.001) were significantly associated with higher ESBG. Schneiderian membrane perforation occurred in 12 sites (11.2%). T1 ESBG/mesiodistal elevation width (MEW) > 0.8 was significantly associated with higher perforation risk (p = 0.011). ESBG and CBL significantly declined during post-loading follow-ups (T4 to T6) compared to T3.
ConclusionsThe strip-cushioning technique led to radiographically detectable ESBG before prosthesis, which appeared related to RBH and implant site. Membrane perforation was more likely with a higher T1 ESBG/MEW ratio. Notably, as challenging anatomical variations did not adversely affect these outcomes, this technique may be considered a viable option in demanding clinical situations.
Clinical relevanceThe strip-cushioning TSFE should be considered a viable option for sinus floor elevation in cases with challenging maxillary sinus anatomical variations.