Radiologic comparative analysis between saline and plateletrich fibrin filling after hydraulic transcrestal sinus lifting without adjunctive bone graft: A randomized controlled trial

Abstract

Objectives: To evaluate implant survival rate, any complications, and changes in residual

alveolar bone height (RABH) using saline or platelet-rich fibrin (PRF) filling after

hydraulic transcrestal sinus lifting.

Methods: Dental implants were placed after hydraulic transcrestal sinus lifting and

the filling of saline (20 patients) or PRF (20 patients). Outcome measurements were

implant survival, any complications, and RABH changes. Cone-beam computed tomography

(CBCT) scans were taken and compared preoperatively (T0), immediately

postoperatively (T1), at 3 months (T2), 6 months (T3), and 12 months postoperatively

(T4), respectively.

Results: In a total of 40 patients, 45 implants with a mean length of 10.4 ± 0.8 mm

were placed in posterior maxilla of a mean RABH of 6.8 ± 1.1 mm. The increase in

RABH peaked at T1, and continuous drooping of the sinus membrane was observed

but stabilized at T3. Meanwhile, the gradual increase in the radiopacities was found

below the lifted sinus membrane. The PRF filling induced the radiographic intrasinus

bone gain of 2.6 ± 1.1 mm, which was significantly more than 1.7 ± 1.0 mm of saline

filling at T4 (p < .05). All the implants were in function with no significant complications

over the one-year follow-up period.

Conclusions: In this randomized case–control study, the feasibility of hydraulic transcrestal

sinus lifting without bone graft was confirmed and PRF might be a better

filler to support the elevated sinus membrane. However, adjunctive bone grafting

should still be indicated for cases requiring more than 2–3 mm of intrasinus bone

gain.