Osteotomy and membrane elevation during the maxillary sinus augmentation procedure. A comparative study: piezoelectric device vs. conventional rotative instruments

OBJECTIVES: The aim of the present study was to investigate in a randomized-controlled clinical trial the performance of rotary instruments compared with a piezoelectric device during maxillary sinus floor elevation. MATERIALS AND METHODS: Thirteen patients who required a bilateral maxillary sinus augmentation for implant-prosthetic rehabilitation were included in this study. A within-patient control study was carried out. The osteotomy for sinus access was performed on one side of the maxilla using the piezosurgery (test sites) and on the other side using conventional rotary diamond burs (control sites). The parameters recorded were as follows: bony window length (L), bony window height (H), bone thickness (T) and osteotomy area (A)--calculated by multiplying L and H. In addition, the time necessary for the osteotomy and sinus membrane elevation as well as the number of surgical complications were calculated. RESULTS: The mean length and height of the bone window were similar in both groups. The osteotomy area (A) obtained by multiplying L and H was wider in the control group (151.2 +/- 20.4 mm(2)) compared with the test group (137 +/- 24.2 mm(2)). The time necessary for the osteotomy and the sinus membrane elevation with conventional instruments was 10.2 +/- 2.4 min, while with the piezoelectric device it was 11.5 +/- 3.8 min. Moreover, membrane perforation occurred in 30% of the maxillary sinuses in the test group and in 23% of the control group. None of the differences observed between the two groups reached a level of significance. CONCLUSIONS: Within the limits of the present study, it may be concluded that piezosurgery and conventional instruments did not show any differences in the clinical parameters investigated for the maxillary sinus floor elevation.