Reamer-mediated transalveolar sinus floor elevation without osteotome and simultaneous implant placement in the maxillary molar area: clinical outcomes of 391 implants in 380 patients.

OBJECTIVES: Minimally invasive sinus elevation and augmentation using a transalveolar approach can reduce perioperative complications and patient discomfort. A specially designed reamer accomplishes this without the use of an osteotome or a mallet. The objective of this study is to present this technique with relevant clinical cases and patient outcomes. MATERIAL AND METHODS: Series of reamers with one cutting and one reaming edge were used to prepare an osteotomy site for posterior maxillary areas. A total of 391 osteotomies were prepared with the reamer in 380 patients, and 373 implants were placed simultaneously. In addition to the procedure's success parameters, levels of intraoperative patient comfort were monitored using a visual analogue scale. RESULTS: The mean height of the residual alveolar process was 5.8 (0.9) mm, whereas mean elevation of the sinus floor was 6.2 (0.4) mm. Eighteen (4.6%) Schneiderian membrane perforations occurred, and the 2-year survival rate was 95.4%. The success rate was 92.7% in sites with thin sinus floors (< 4 mm) and 96.4% in sites with greater bone height (> 4 mm). None of the patients experienced any discomfort during the procedure. CONCLUSIONS: Within the limits of the present study, it can be concluded that reamer-mediated transalveolar sinus floor elevation is a reliable method for implant placement in the posterior maxilla, even at sites with ≤ 4 mm of residual alveolar bone height. This reamer-mediated procedure is less invasive than traditional osteotomy and can minimize patient discomfort during sinus floor elevation.