Instrumental and laboratory indicators in evaluating the effectiveness of subantral sinus lifting in severe bone atrophy

Background. Implant dentistry is becoming one of the most popular rehabilitation strategies for patients with partial or complete secondary edentia, which dictates the need to develop innovative osteoplastic materials and surgical bone reconstructive techniques. Objective. Conduct an objective assessment of the effectiveness of various types of sinus lift using instrumental and laboratory criteria Material and methods. The results of surgical treatment of 50 patients (19 men (38%) and 31 women (62%)) aged 29—72 years with dentition defects and atrophy of the alveolar process of the upper jaw were analyzed. 30 patients (group 1) underwent closed sinus lift surgery using the author’s technique with simultaneous implantation, 20 (group 2) underwent open sinus lift surgery. Control examinations were carried out in both groups before surgery, 3, 6 and 12 months after dental implantation. We assessed: the incidence of complications, primary and secondary stability, the percentage of dental implant rejections, and the electrokinetic mobility of buccal epithelial cells. Results. In patients of group 1, no intraoperative complications were registered; the sutures were removed on the 7th day; no delayed complications were identified. In group 2, bleeding from the alveolar arterioles was observed in 4 patients during the operation, and perforation of the Schneiderian membrane was observed in 2 patients. In the early postoperative period, non-critical vascular phenomena (edema and hematomas) were observed. Sutures were removed on days 10—14. The primary stability indicators of the torque test were 31.1 n/m and 9.4 n/m, periosteometry –2.15 and –1.42, in groups 1 and 2, respectively. Indicators of secondary stability at 12 months of follow-up were 51.9n/m and 46.3n/m, –8.76 and –6.95, respectively. Conclusion. The developed method of closed sinus lift, performed in conditions of severe bone tissue atrophy, reduces the invasiveness of bone augmentation, helps reduce the number of intra- and postoperative complications and accelerates the rehabilitation process of patients with secondary adentia.