Sinus Lift: Graft or No Graft?

We wanted to bring up a discussion on the practical experience with clinicians with sinus floor elevation using graft material or not using graft. A recent study 1 analyzed this topic via a comprehensive literature search and concluded that:

High long-term implant survival was demonstrated after osteotome-mediated sinus floor elevation with or without a grafting material. However, long-term randomized controlled trials comparing the 2 treatment modalities are sparse. Read More

Have you had tried both approaches in your practice? What has been your experience with long-term outcomes with sinus floor elevation with or without a grafting material?

1.Osteotome-Mediated Sinus Floor Elevation With or Without a Grafting Material: A Systematic Review and Meta-analysis of Long-term Studies (≥5-Years).. Implant Dent. 2018 Aug;27(4):488-497. Aludden H

4 thoughts on: Sinus Lift: Graft or No Graft?

  1. Rakshith says:

    Sinus lift without grafting works well when there is about 4 to 5 mm of native bone is present . When done without grafting we need to make sure there is no perforation in the membrane . If there is a perforation then the clot does not get stabilised which would hamper bone regeneration in the sinus

  2. Ricardo Righesso says:

    In the last 20 years I have done a considerable number of Sinus Lift. I have always used Lyophilized bone, sometimes nationally and sometimes not. I use the conventional window technique. I have also used Prp and prf and saw no additional benefits. I have had cases that occurred with the perforation of the membrane and I continued the surgery only installing a collagen membrane.
    I believe that the technique works, but not always the expected result is obtained. We are not sure about what kind of material we are installing our implants (new bone, new bone and remains of the inserted material or even on the inserted material with traces of fibrosis).
    Randomized and long-term studies are few and the technique varies too much. No doubt more studies are needed.

    • Ricardo Righesso says:

      In the vast majority of my cases, Sinus Lift was performed on total edentulous. Patients who have used Total Prostheses for many years. Soon the need for bone was great. I believe, but for the cost, few times I realized that before implant installation and after radiographic confirmation of bone neoformation, we should, via trephines, obtain a sample of the newly formed material and only after implanting the implants.

      • Ricardo Righesso says:

        Some authors say that simple sinus membrane displacement and bleeding would already be sufficient for bone neoformation. Few and rare are studies with this type of technique. So it lacks proof.
        Other studies say that autogenous grafts are equal in final outcome compared to the use of lyophilized bone. Therefore, there are countless studies that preach the use of lyophilized bone as the provider of the best result. But they are not standardized studies, do not have long periods of follow-up and many doubts persist. Coupled with all this, a large number of scientific studies in this area are sponsored by the manufacturers of the products, this fact, which at least makes the results suspicious.
        For the great majority of us, Latin American professionals, the use of “Growth Factors”, due to its high cost, is still not feasible in the clinic. But this also needs further studr

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This entry was posted in Clinical Questions, Regenerative, Surgical and tagged .