Comparative Evaluation of Crestal and Lateral Sinus Lift Techniques for Implant Rehabilitation: A Clinical Study

Abstract

Background:

Maxillary sinus floor elevation is a well-established procedure for implant rehabilitation in the posterior maxilla with insufficient residual bone height. Among the available techniques, the crestal and lateral sinus lift approaches are the most commonly performed; however, their comparative clinical outcomes remain a subject of ongoing investigation.

Aim:

To compare the clinical outcomes of crestal and lateral sinus lift techniques for implant rehabilitation in patients with posterior maxillary bone deficiency

Materials and Methods:

This prospective comparative clinical study included 40 patients requiring implant-supported rehabilitation in the posterior maxilla. Patients were equally allocated into two groups: Group I (Crestal sinus lift, n = 20) and Group II (Lateral sinus lift, n = 20). Clinical parameters evaluated included operative time, postoperative pain using the Visual Analogue Scale (VAS), implant stability quotient (ISQ) at baseline, 3 months, and 6 months, vertical bone augmentation, marginal bone loss, implant survival, Schneiderian membrane perforation, soft tissue healing, and patient satisfaction. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Continuous variables were compared using the Independent Samples Student's t-test, while categorical variables were analyzed using the Chi-square or Fisher's Exact test. Statistical significance was set at p < 0.05.

Results:

The demographic characteristics were comparable between the two treatment groups, with no significant differences in age or gender distribution (p > 0.05). The crestal sinus lift group demonstrated a significantly shorter operative time (31.80 ± 4.90 vs. 54.20 ± 7.10 minutes; p < 0.001), lower postoperative pain scores (2.80 ± 0.90 vs. 4.60 ± 1.10; p = 0.002), and higher patient satisfaction (9.10 ± 0.74 vs. 8.35 ± 0.88; p = 0.021). In contrast, the lateral sinus lift group achieved significantly greater vertical bone augmentation (7.28 ± 1.12 mm vs. 3.82 ± 0.79 mm; p < 0.001). Implant stability increased progressively from baseline to six months in both groups, with no significant differences between the groups at baseline, three months, or six months (p > 0.05). Marginal bone loss, implant survival (100% vs. 95%; p = 1.000), Schneiderian membrane perforation (0% vs. 15%; p = 0.072), and soft tissue healing were also comparable between the two groups (p > 0.05). The overall implant survival rate at the six-month follow-up was 97.5%.

Conclusion:

Both crestal and lateral sinus lift techniques provided predictable clinical outcomes and high implant survival rates for implant rehabilitation in the posterior maxilla. The crestal approach was associated with shorter surgical time, reduced postoperative discomfort, and greater patient satisfaction, whereas the lateral approach achieved significantly greater vertical bone augmentation, making it preferable in cases with severe posterior maxillary bone deficiency. Treatment selection should therefore be guided by the available residual bone height and the extent of augmentation required.