Crestal sinus lift for implant rehabilitation: a randomised clinical trial comparing the Cosci and the Summers techniques. A preliminary report on complications and patient preference.
OBJECTIVE
To compare the effectiveness of two different techniques to lift the maxillary sinus via a crestal approach: the Summers versus the Cosci technique.


METHODS
Fifteen partially edentulous patients missing bilaterally maxillary molars and/ or premolars having 4 to 7 mm of residual crestal height and at least 5 mm thickness below the maxillary sinuses measured on computed tomography scans were randomised to have implants placed in sinuses crestally lifted according to the Cosci or Summers technique with bone substitutes according to a split-mouth design. Implants were left to heal submerged for 6 months. Implants were loaded with acrylic provisional crowns/prostheses. Screw-retained definitive metal-ceramic prostheses were delivered 4 months after provisional loading. Outcome measures were prosthesis and implant failures, any complications, operation time, operator preference, and patient preference assessed 1 month after surgery and 1 month after delivery of the final prostheses by a blinded outcome assessor. All patients were followed up to 5 months after loading (1 year after implant placement).


RESULTS
Nineteen study implants were placed according to each technique. No patient dropped out and no implant failed. No discomfort/complications occurred at sites treated with the Cosci technique whereas 12 patients reported discomfort during the augmentation procedure at the side treated with the Summers technique, this was statistically significant, and in one of these patients a perforation of the sinus membrane occurred. Postoperatively, headache was reported by nine patients and swelling occurred in three of these patients at the Summers treated sides. Statistically significantly less time was required to place implants according to the Cosci technique (33 versus 24 minutes, on average). The two operators and 14 out of 15 patients preferred the Cosci technique.


CONCLUSIONS
Both crestal sinus lift techniques were successful but the Cosci technique required less surgical time, produced less intra- and postoperative morbidity and was preferred by patients.
Checchi
Luigi
L
Department of Periodontology and Implantology, University of Bologna, Bologna, Italy.
Felice
Pietro
P
Antonini
Elisa Soardi
ES
Cosci
Ferdinando
F
Pellegrino
Gerardo
G
Esposito
Marco
M
D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D018786:Bone Substitutes / Q000627:therapeutic use; D003442:Crowns; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003794:Dental Restoration, Temporary; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D057240:Patient Preference; D011183:Postoperative Complications; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
D018786:Bone Substitutes; D015921:Dental Implants