Morbidity following transcrestal and lateral sinus floor elevation: A randomized trial

Aim: To comparatively evaluate the morbidity following maxillary sinus floor elevation according to either transcrestal (tSFE) or lateral (lSFE) approach with concomitant implant placement. Materials & Methods: Patients with ≥1 edentulous maxillary posterior site with residual bone height (RBH) of 3–6 mm were enrolled. tSFE was performed in association with a xenograft and a collagen matrix. For lSFE, the sinus was grafted with the xenograft, and the antrostomy was covered with a membrane. Implants were inserted concomitantly. The postoperative course was assessed through questionnaires. Pain level (VASpain) was recorded using a 100-mm visual analogue scale. Results: Twenty-nine and 28 patients were included in tSFE and lSFE group, respectively. On the day of surgery, VASpain was significantly higher for tSFE compared to lSFE, and similar from day 1 to 14. tSFE was characterized by significantly lower incidence of swelling, bruising and nasal discharge/bleeding. Significantly less severe limitation in swallowing, continuing daily activities, eating, speaking, opening the mouth and going to school/work was found for tSFE only at specific postsurgery intervals. Conclusions: lSFE was associated with lower pain on the day of surgery, and tSFE revealed lower postoperative morbidity as well as more tolerable postoperative course.