Rotary Transcrestal Sinus Floor Elevation With Simultaneous Implant Placement

To evaluate the clinical and radiographic outcomes of rotary transcrestal sinus floor elevation without bone grafting with simultaneous implant placement. Twenty-nine patients received 32 implants with simultaneous rotary transcrestal sinus floor elevation(rotary technique). The rotary technique was performed concurrently with implant osteotomy preparation. First, a pilot drill was used to create the initial osteotomy and to perforate the cortical bone of the sinus floor with scrupulous attention to detail. Subsequently, step drills are employed to widen the implant bed and the sinus floor. Finally, the implant apex loaded with autologous concentrated growth factors (CGF) was advanced to achieve concurrent membrane elevation and implant placement. Parameters evaluated included the frequency of intraoperative Schneiderian membrane perforation and postoperative swelling, vertical bone gain in the sinus and implant survival rates. All implant sites achieved osseointegration with favorable prosthetic rehabilitation. Radiographic evaluation demonstrated significant new bone formation around implants, exhibiting a mean height of endo-sinus bone gain(5.05±1.09 mm). Without using osteotome and mallet, this technique significantly reduced intraoperative discomfort and postoperative swelling incidence. The Schneiderian membrane perforation rate remained at 3.1%(1/32), while implants survival maintained at 100% during follow-up. The rotary technique lifts the sinus and places the implant in one step using gentle drilling. It’s less invasive, more comfortable during the procedure, and reduces the postoperative morbidity. Despite the limitations of the present study, it seems that the rotary technique can achieve satisfactory therapeutic effect and high success rate.