Kamal Esraa Salem, Shaaban Ahmed, Melek Lydia
MSc Student at Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, 58 Mohammed Safwat St., Kafr Abdo-Roshdy, Alexandria, 21529, Egypt.
Oral Maxillofac Surg. 2025 Sep 20;29(1):158. doi: 10.1007/s10006-025-01459-8.
This study aimed to assess the clinical and radiographic outcomes of transcrestal maxillary sinus lifting using Densah burs in combination with activated plasma albumin gel (APAG) during simultaneous implant placement in cases with severely limited residual bone height (3-5 mm).
A total of six patients with missing posterior maxillary teeth and insufficient alveolar bone height were treated using the osseodensification technique with Densah burs and APAG. CBCT scans were obtained preoperatively and six months postoperatively to evaluate changes in bone height and peri-implant bone density. Bone density was estimated using CBCT gray values derived from OnDemand 3D software, recognizing that these values provide relative rather than absolute measurements and are subject to inherent limitations.
No post-operative complications were recorded, and the sinus membrane remained intact in all cases. After six months, a statistically significant bone height gain was observed (mean 5.28 ± 0.70 mm; p < 0.001), along with a significant increase in bone density (mean difference 255.15 ± 95.69 HU; p < 0.001). Implant stability showed no statistically significant difference between primary and secondary ISQ values (mean difference 1.17 ± 4.31; p = 0.54).
The combined use of Densah burs and activated plasma albumin gel for transcrestal sinus lifting appears to be a safe and minimally invasive technique, promoting substantial bone height gain and improved peri-implant bone density. The bioactive plasma gel played a key role in effective sinus membrane elevation and vertical bone augmentation.
This trial was retrospectively registered on ClinicalTrials.gov (ID: NCT06360263) in July 2023.
本研究旨在评估在剩余骨高度严重受限（3 - 5毫米）的病例中，在同期种植体植入期间使用Densah钻联合活性血浆白蛋白凝胶（APAG）进行经牙槽嵴上颌窦提升的临床和影像学结果。
共有6例上颌后牙缺失且牙槽骨高度不足的患者接受了使用Densah钻和APAG的骨致密化技术治疗。术前和术后6个月进行CBCT扫描，以评估骨高度和种植体周围骨密度的变化。使用从OnDemand 3D软件获得的CBCT灰度值估计骨密度，认识到这些值提供的是相对而非绝对测量值，并且存在固有局限性。
未记录到术后并发症，所有病例的窦膜均保持完整。6个月后，观察到骨高度有统计学意义的增加（平均5.28±0.70毫米；p < 0.001），同时骨密度也有显著增加（平均差异255.15±95.69 HU；p < 0.001）。种植体稳定性在初次和二次ISQ值之间无统计学显著差异（平均差异1.17±4.31；p = 0.54）。
Densah钻和活性血浆白蛋白凝胶联合用于经牙槽嵴窦提升似乎是一种安全且微创的技术，可促进显著的骨高度增加和改善种植体周围骨密度。生物活性血浆凝胶在有效的窦膜提升和垂直骨增量中起关键作用。
本试验于2023年7月在ClinicalTrials.gov（ID：NCT06360263）上进行回顾性注册。
