Context: Tooth absence is a pervasive oral condition and mostly occurs as maxillary tooth absence. The only way to treat tooth absence in adults is prosthesis implantation, and implant therapy usually requires repair of the maxillary sinus to its original state using a maxillary sinus lift (MSL). MSL has usually included bone augmentation with bone grafting simultaneously with the placement of the dental implant.
Objective: The study intended to examine the clinical effects of placement of dental implants using the hydraulic maxillary sinus lift (MSL), without bone grafting, to offer new guidance, to make suggestions for future clinical treatment of tooth absence, and also to lay a reliable foundation for subsequent research on MSL without bone grafting.
Design: The research team designed a randomized controlled trial.
Setting: The study occurred at Suzhou Kowloon Hospital at the Shanghai Jiaotong University School of Medicine in Suzhou, China.
Participants: Participants were 68 patients at the hospital with tooth defects between February 2019 and December 2019.
Intervention: Participants were randomly assigned to the intervention group or the control group. Both groups received dental-implant placement in the hydraulic MSL, but the intervention group's surgery didn't include bone grafting, while the control group's included simultaneous bone grafting.
Outcome measures: Participants' surgical experience were evaluated using a visual analog scale (VAS) and the General Comfort Questionnaire (GCQ), and inflammatory factors were quantified using an enzyme-linked immunosorbent assay (ELISA). Participants' periodontal conditions after surgery were assessed, using tests for bone mineral density (BMD), periodontal probing depth (PPD), clinical attachment level (CAL), plaque index (PLI), and bleeding index (BI) as well as measurements of the implant retention rate, new bone acquisition around implants, and vertical bone loss. Participants' surgical costs were also evaluated. At a one-year follow-up, a masticatory function score and the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36) were used for an evaluation of participants' prognoses.
Results: The intervention group had a significantly lower incidence of postoperative adverse reactions, lower intraoperative blood loss, and shorter operation time than did the control group (all P < .05). After surgery at week1, the intervention group showed significantly lower levels of inflammatory factors than the control group did (all P < .05). Postoperatively at month 6, the intervention group had a significantly higher implant retention rate than did the control group (P < .05).
Conclusions: Simultaneous implant placement in a hydraulic MSL without bone grafting can deliver favorable therapeutic effects, with a high safety profile, which can effectively optimize the surgical process, improve patients' postoperative feelings, and reduce surgical expenses, making it easy to popularize clinically.