Flapless osteotome‐mediated sinus floor elevation using platelet‐rich fibrin versus lateral approach using deproteinised bovine bone mineral for residual bone height of 2–6 mm: A randomised trial.

Objectives: To evaluate patient‐reported outcomes and radiographic results of simultaneous implant placement in severely atrophic maxilla using flapless endoscope‐assisted osteotome sinus floor elevation with platelet‐rich fibrin (PRF), also defined as PESS, and to compare the results with those of lateral sinus floor elevation (LSFE). Methods: Patients with a residual bone height (RBH) of 2–6 mm were included in a randomised controlled trial. PESS was performed with PRF as the sole grafting material. LSFE was performed using deproteinised bovine bone matrix. Patient‐reported outcomes were recorded on a visual analogue scale (VAS‐pain) and visual rating scale (VRS‐swelling and VRS‐willingness). Peri‐implant bone height (PBH), bone mineral density (BMD) and sinus grafting remodelling index were measured using CBCT immediately postoperatively and 3rd, 6th and 18th months post‐surgery. Results: The study population consisted of 20 patients in each group. The RBH of two groups averaged 3.35 ± 0.79 mm and 2.92 ± 0.63 mm with no significant difference (p >.05). VAS‐pain was 18.0 (IR 15.0–22.5) and 35.0 (IR 32.5–37.0) in the PESS and LSFE groups, respectively (p <.01). VAS‐pain decreased with time in both groups. VRS‐swelling was lower in the PESS group than LSFE group. VRS‐willingness was higher in the PESS group than LSFE group (p <.01). At 18 months post‐surgery, the marginal bone loss was 0.60 ± 0.25 mm and 0.69 ± 0.35 mm in the two groups with no significant difference (p =.52). Conclusions: Within the limitations of this study, PESS was associated with lower postoperative morbidity and was more tolerable than LSFE. PESS could be a reliable procedure for sinus floor elevation in patients with insufficient RBH. [ABSTRACT FROM AUTHOR]