Patient Perception and Radiographic Assessment of Sinus Lifting Procedure
Patient Perception and Radiographic Assessment of Sinus Lifting Procedure
This study aimed to evaluate the clinical complications that might be presented with
 osteotome and densah burs, as well as to assess the new bone generated at 6 months
 post-operatively using CBCT. The study hypothesis was that densah bur would show comparable
 results to osteotome-mediated sinus lifting
Maxillary posterior edentulous area rehabilitation with implants is usually not an easy
 procedure and is considered a challenge to many prosthodontists. This is due to
 pneumatization of the maxillary sinus, poor bone density and volume, and difficult
 accessibility of this area. After tooth loss, the maxillary sinus tends to enlarge into the
 remaining residual ridge because of poor bone density and lack of functional stimulation by
 teeth.1 Rehabilitation with dental implants in the maxillary posterior area depends on the
 quantity and quality of bone available for implant placement. In order to place the implant
 in the best prosthetic position, regenerative surgical techniques are usually essential to
 correct the initial anatomical situation.2 Summer in 1994 introduced a less invasive
 technique than the lateral approach for sinus floor elevation, called the closed sinus
 lifting. Summer classified it in to osteotome sinus floor elevation and bone added osteotome
 sinus floor elevation. Osteotome depends on condensing the bone in implant bed site and
 pushing it laterally and upward, which raises the sinus floor. Although being successful and
 non-invasive, Summer's technique showed several surgical problems as heat generation-induced
 necrosis if not well irrigated, and delayed implant secondary stability, as well as some
 patient-related drawbacks as headache and vertigo.3 Fortunately, in 2014 Salah Huwais
 introduced new burs called densah burs that help preservation of bone health by condensing
 bone rather than removing it. Accordingly, this process was labeled osseodensification. In
 the past few years since the introduction of densah burs, limited number of studies evaluated
 its efficiency as well as patient perception to the procedure. 4 It is well established that
 cone beam computed tomography (CBCT) gives more profound and accurate assessment of pre- and
 post-operative implant sites. However, a meta-analysis was published in 2018 showed that most
 previous studies on lifting procedures used conventional 2D techniques, and very few applied
 CBCT as the diagnostic modality. This heterogeneity highly affected the quality of evidence
 retrieved. 5 This study aimed to validate the clinical complications that might be presented
 with osteotome and densah burs, as well as to assess the new bone generated at 6 months
 post-operatively using CBCT. The study hypothesis was that densah bur would show comparable
 results to osteotome-mediated sinus lifting.
Inclusion Criteria:

 -  the residual bone height at the site of implant placement was 8 mm or less. All
 patients were in a good health, non-smokers with no systemic, immunologic or
 debilitating diseases that could affect normal bone healing. Their edentulous ridges
 were covered with optimal thickness of mucoperiosteum with no signs of inflammation,
 ulceration or scar tissue and sufficient inter arch space was adequate for future
 prosthesis

 Exclusion Criteria:

 -  smokers bad oral hygiene systemic disease