Implant placement in posterior atrophic maxilla using direct and indirect sinus augmentation- a comparative study

Objective: To evaluate the most efficacious method for implant placement in posterior atrophic maxilla by assessing morbidity, bone height gained around implants and ability to load after 3 months based on ISQ values. Material & Method:20 partially edentulous patients were selected and divided into 2 groups equally. Residual bone height at least 5 mm or less was selected for direct sinus lift in Group I and more than 5 mm for indirect sinus lift in Group II. In Group I sinus augmentation was performed using lateral window technique using Surgiwear xeno graft and in Group II indirect sinus augmentation technique without using bone graft. Implants were submerged and left for 3 months before evaluating. Results: The comparison of bone height post-operative to 3 month showed mean bone loss of 0.49 mm in Group I, whereas Group II showed mean bone height gain, 1.43 mm, indicating in indirect sinus lift new bone was formed around the implant. Values of RFA in Group І showed mean ISQ 45 after 3 month. Group ІІ showed mean ISQ 74 after 3 months which is superior to the Group І values (P value 0.001) showing osteointegration was adequate in indirect sinus lift after 3 months. Conclusion: In atrophic maxilla bone height ≥5 mm indirect sinus augmentation is better technique for implant placement and for loading within 3 months and more than 3 months of waiting period is needed for implant placed in a bone height of 5 mm or less using direct sinus augmentation