The endoscopically controlled osteotome sinus floor elevation: a preliminary prospective study.
OBJECTIVE
It was the aim of the present prospective study to quantify the gain in height of implant sites by endoscopically controlled osteotome sinus floor elevations (ECOSFE) with simultaneous implant placement and to report the number of sinus membrane perforations.


METHODS
From October 1999 to December 2000, of 92 sinus floor elevations, 18 were carried out endoscopically controlled with an osteotome technique. As augmentation material, beta-tricalcium phosphate (beta-TCP) or autogenous bone was used; 22 implants were placed.


RESULTS
The residual height of the alveolar crest in the posterior maxilla was 6.8 +/- 1.6 mm on average. The implant lengths ranged from 10 to 16 mm (mean implant length 12.2 +/- 1.4 mm). They were significantly larger than the residual height of the alveolar crests (P < .0005). Elevation of the sinus floor with an osteotome had to be supported by conventional sinus floor elevation instruments after a mean elevation of 3.0 +/- 0.8 mm to prevent perforation of the sinus membrane. However, 1 perforation occurred, which was repaired with a periosteal patch. At stage 2 surgery, 2 implants were removed because of mobility. Endoscopic control revealed one case in which beta-TCP could be found within the sinus; another case showed areas of polypoid mucosa on the sinus floor.


CONCLUSIONS
With the ECOSFE, perforations of the sinus membrane can be visualized; however, they cannot be avoided. Although this technique is less invasive than the lateral window technique, it cannot be recommended as a standard procedure in the posterior maxilla because of the large amount of additional equipment needed and the technically demanding procedure.


CONCLUSIONS
The use of the ECOSFE should be confined to scientific trials.
Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Germany. emeka.nkenke@mkg.uni-erlangen.de
Emeka
E
Nkenke
Andreas
A
Schlegel
Stefan
S
Schultze-Mosgau
Friedrich W
FW
Neukam
Jörg
J
Wiltfang
D000328:Adult; D000368:Aged; D018786:Bone Substitutes; D016025:Bone Transplantation; D002130:Calcium Phosphates; D003758:Dental Implantation, Endosseous; D017268:Dental Prosthesis Retention; D019232:Dental Restoration Failure; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000293:injuries / Q000601:surgery*; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D013516:Oral Surgical Procedures, Preprosthetic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D010865:Pilot Projects; D011446:Prospective Studies
D018786:Bone Substitutes; D002130:Calcium Phosphates; C485817:beta-tricalcium phosphate; C018392:tricalcium phosphate