Radiographic Analysis of a Transalveolar Sinus-Lift Technique: A Multipractice Retrospective Study With a Mean Follow-Up of 5 Years

BACKGROUND: Various sinus-lift techniques have been described in the literature. The aim of this retrospective study is to evaluate the efficacy of a transalveolar sinus-lift technique in terms of implant survival, marginal bone loss, and complications. METHODS: A total of 538 patient records were examined, and after applying exclusion and inclusion criteria, a sample of patients was included with a mean follow-up of 5 years. Implants with a smooth or tapered surface were considered. Therefore, only sinus lifts with inorganic bovine bone matrix or demineralized bone matrix were included, and 1,536 periapical radiographs were analyzed. Outcome measures were implant success, implant failure (peri-implantitis and loss of osseointegration), marginal bone resorption, and biologic complications (membrane perforations, sinusitis, and intraoperative and/or postoperative hemorrhage). Periapical radiographs were evaluated before surgery, post-surgery, and after 6 months and 1, 3, and 5 years. We analyzed the residual crestal bone height under the sinus, the amount (mm) of height increase after surgery, and values of implant marginal bone resorption for considered follow-ups. RESULTS: Two hundred eighty-two (282) patients were excluded. Therefore, 256 patients treated with the transalveolar sinus-lift technique were included. A total of 376 dental implants and 323 sinus lifts were analyzed. The overall rates of implant success and failure were 94.9% and 5.1%, respectively. The mean bone loss around implants was 1.98 mm (mean follow-up of 5 years). Patients treated with inorganic bovine bone matrix showed a better implant success rate (P = 0.03) than did patients treated with demineralized human matrix. Three Schneiderian membrane perforations occurred in the 323 sinus lifts. In these cases, the surgeon performed another surgical operation after 3 months. Postoperative complications were peri-implantitis (six cases) and osseointegration losses (13 cases). CONCLUSIONS: The transalveolar sinus-lift technique was a safe, minimally invasive technique with an implant success rate comparable to traditional implantology. The implant success rate was positively affected by the low-resorption graft material, and a low bone-resorption rate around implants was found.