Effect of Changing Grafting Sequences During Sinus Lifting & Simultaneous Implant Placement in the Gained Bone Using Customized Surgical Guide

Maxillary sinus floor augmentation (MSFA) is a common procedure to restore vertical bone defects in the posterior maxilla to allow for oral rehabilitation using dental implants. However, traditional techniques can have demerits such as increased operative time, liability to infection, and increased complication rates. Despite advancements made to improve the surgical technique, several complications can yet arise which may compromise the success of the operation.

This study aims to enhance surgical sequences and compare the efficacy of sinus elevation, implant, and bone graft procedures using a customized surgical guide. The guide includes a lateral window for sinus elevation and a drill guiding hole for implant replacement. The study hypothesizes that the modified sequence (sinus elevation, bone graft, implant) is more accurate and provides better outcomes regarding bone density, stability, and height of the gained bone compared to the traditional sequence (sinus elevation, implant, bone graft).

Inclusion criteria

• Age more than 18 years.
• Both sexes.
• Patients eligible for maxillary sinus elevation, implant, and bone graft procedures.
• Adequate general health for dental interventions.
• Vertical bone measurement of 5 mm or slightly more.

Exclusion criteria

• Systemic conditions affecting implant success.
• Patients with vertical bone measurement less than 5 mm.
• Previous sinus surgery or dental implant failure.
• Medication that can impair or interfere with normal bone metabolism.
• History of head and neck radiotherapy.
• Pregnancy.