Augmentation of the maxillary sinus floor: periosteal elevation versus autogenous bone and xenogenic material

At the department Cranio-Maxillofacial Surgery of Maastricht University Medical
Center (MUMC) the routine procedure for sinus floor elevation prior to dental
implant insertion is augmentation with a mixture of autogenous bone and
xenogenous bone, which adds morbidity due to the donorsite.
We want to augment the maxillary sinuses without using any substitutes by
placing only a resorbable barrier to elevate the Schneiderian membrane of the
floor of the sinus. Bone will be regenerated using the periosteal capacity of
osteoinduction.
Hypothesis: In the atrophic maxilla periosteal elevation with a resorbable
membrane in the sinuses creates sufficient and reliable bone for later dental
implant insertion.

To compare the efficacy of two different techniques for the augmentation of the
atrophic maxilla.

This is a pilot randomised controlled clinical trial

This will be a split mouth study design. The sinus will be approached by the
lateral window technique. On one side a resorbable barrier will be placed to
create a space which will be replaced through newly formed bone. On the other
side a mixture of autogenous bone from the crista iliaca anterior and xenogenic
bone is used to augment the sinus.

The patient must visit the clinic as often as in a standard treatment. No extra
visits are needed.
The benefit of participating in this study is less donor site morbidity,
because only half of the amount of autogenous bone is grafted. Second benefit
is that the risk related to the use of xenogenous bone substitutes is reduced
(slow sinus infections, Creutzfeldt-Jakob disease, etc.).
The risk associated with participation is the presence of insufficient bone in
the sinus site with periosteal elevation. In this scenario a second surgery may
be needed.