Sinus Augmentation: Trephine Core vs Osteotome?

There are several approaches suggested for sinus floor augmentation. One such approach is the Bone-Added Osteotome technique, during which the a specific set of osteotome instruments is used to tent the sinus membrane with bone graft material placed through the osteotomy site. Another technique is known as the Trephine Core Procedure. In this procedure, after raising a mucoperiosteal flap, a trephine is used to create a round bone cut 4“5 mm above the crest of the alveolar ridge and inferior to the sinus floor by several millimeters. The outer bony cortex is removed gently to avoid tearing the membrane, and the exposed membrane is then lifted from the sinus floor using osteotomes. ¹. There are advantages and disadvantages to each technique. But, which technique produces better results in a clinical setting? A recent study ² set out to compare both by randomly assigning a patient to either the trephine core procedure or the bone-added osteotome sinus floor elevation technique.

The conclusion:

While both of the procedures resulted in an increase in bone fill and bone height, there were no significant differences between the techniques. No significant differences were observed between the two groups for implant stability quotient values after implant placement. No significant differences were observed between the two groups for measures of healing, swelling, and pain. Based upon this study that compared the trephine core procedure with the bone-added osteotome sinus elevation technique, comparing bone height, bone fill, and primary implant stability, the two procedures appeared to perform in an equivalent fashion.²Read More

Which technique do you use in your practice and does this research accord with your clinical experience?

1.Trephine Core: An Alternative Sinus Lift Technique. J Oral Implantol. 2014 Jul;40 Spec No:391-6 Lanka Mahesh, BDS, MS et al.

2.Trephine Core Procedure Versus Bone-Added Osteotome Sinus Floor Elevation in the Augmentation of the Sinus Floor: A Comparative Clinical and Radiographic Study.. Int J Oral Maxillofac Implants. 2018 Mar/Apr;33(2):425-432. Chandra RV, et al.