Comparison of pre-loading stability values of implants placed simultaneously with grafted and graftless external sinus floor elevation

Objective: Maxillary sinus augmentation is performed to rehabilitate the atrophic posterior maxilla with implant-supported prosthetic restorations. While many researchers have evaluated various bone graft materials in the maxillary sinus cavity, studies have shown that even simple elevation of the Schneiderian membrane can stimulate bone growth in the sinus. The aim of this study was to quantitatively evaluate and compare the osseointegration of implants placed simultaneously with external sinus floor elevation with and without graft material prior to prosthetic loading. Method: From July 2023 to June 2024, a retrospective archive search was conducted on the patients at the Akdeniz University Faculty of Dentistry's Department of Oral and Maxillofacial Surgery, who had dental implants placed simultaneously with grafted and graftless external sinus floor elevation and underwent routine ISQ measurements at six months postoperatively. 9 male and 15 female patients aged 34–69 who met the inclusion criteria for clinical data were included in the study. For the data that met the assumptions of parametric distribution, the difference between the two means was tested for statistical significance to compare the grafted and graftless groups. Results: Of the 21 implants placed in the graftless group, one failed during the prosthetic loading phase. The early survival rate for this group was determined to be 95.2%. No early failures were observed in the grafted group, and the survival rate was determined to be 100%. Considering the records obtained from a total of 42 implants placed with and without graft material, the ISQ values of the two groups were found not to differ significantly when compared using a test for the difference between two means. Conclusion: Although the graftless method may show lower values in radiographic and histomorphometric analyses than the traditional grafted method, it can be considered a successful approach in terms of implant survival and ISQ values, which indicate sufficient osseointegration. Implants placed using the graftless method have similar success rates to implants placed using the traditional method in providing a healthy foundation for the targeted prosthetic restoration. These results highlight the graftless method, particularly given its clear advantages, such as reduced costs and minimized potential complications. Key words: sinus lift, graftless, ISQ