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Effect of Changing Grafting Sequences During Sinus Lifting & Simultaneous Implant Placement in the Gained Bone Using Customized Surgical Guide

Sponsor: Cairo University • ClinicalTrials.gov ID: NCT07816107

Registry updated: 2026-10-16

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Description

The aim of this randomized clinical trial is to evaluate the effect of changing the sequence of bone grafting during maxillary sinus lifting and simultaneous dental implant placement. The study compares a traditional sequence (sinus elevation, implant placement, then bone grafting) with a modified sequence (sinus elevation, bone grafting, then implant placement). Both procedures utilize a customized surgical guide and are performed on patients with a vertical bone measurement of 5 mm or slightly more. The primary goal is to assess bone density, along with secondary outcomes including vertical bone height gained, bone volume, and implant stability.

Interventions

Traditional sequence (Procedure)
The surgical procedure involves the following standardized steps: Creation and elevation of a full-thickness mucoperiosteal flap. Seating of the customized surgical guide. Tracing the lateral window outline using a sterile surgical pencil. Removal of the surgical guide. Lateral window osteotomy and elevation of the Schneiderian membrane. Securing and protecting the elevated membrane using a blunt surgical instrument. Repositioning of the surgical guide. Preparation of the pilot osteotomy through the guide sleeve. Removal of the surgical guide and completion of the implant osteotomy sequence via a freehand approach. Implant insertion and cover screw placement. Packing of the particulate bone graft into the elevated subantral space. Placement of a resorbable biological membrane over the lateral window. Flap repositioning and suturing for primary closure.
Modified sequence (Procedure)
The surgical procedure involves the following standardized steps: Creation and elevation of a full-thickness mucoperiosteal flap. Seating of the customized surgical guide. Tracing the lateral window outline using a sterile surgical pencil. Removal of the surgical guide. Lateral window osteotomy and elevation of the Schneiderian membrane. Securing and protecting the elevated membrane using a blunt surgical instrument. Repositioning of the surgical guide. Preparation of the pilot osteotomy through the guide sleeve. Removal of the surgical guide and completion of the implant osteotomy sequence via a freehand approach. Packing of the particulate bone graft into the elevated subantral space. Implant insertion and cover screw placement through the grafted site. Placement of a resorbable biological membrane over the lateral window. Flap repositioning and suturing for primary closure.

Eligibility criteria

Inclusion Criteria: * Age more than 18 years. * Both sexes. * Patients eligible for maxillary sinus elevation, implant, and bone graft procedures. * Adequate general health for dental interventions. * Vertical bone measurement of 5 mm or slightly more. Exclusion Criteria: * Systemic conditions affecting implant success. * Patients with vertical bone measurement less than 5 mm. * Previous sinus surgery or dental implant failure. * Medication that can impair or interfere with normal bone metabolism. * History of head and neck radiotherapy. * Pregnancy.

Conditions

Vertical Bone Defects Missing Tooth/Teeth

Locations

Faculty of Dentistry, Cairo University — Cairo, Egypt

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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