Intraoperative and postoperative outcomes of sinus floor elevation using the lateral window technique versus the hydrodynamic transalveolar approach: a preliminary randomized controlled trial.

OBJECTIVES: To compare the clinical and radiographic outcomes of two sinus floor elevation techniques: the conventional lateral window technique versus the transalveolar approach using a hydrodynamic ultrasonic device. MATERIALS AND METHODS: The study was designed as a randomized controlled clinical trial, and participants were randomly allocated to the control group (lateral window: LW) or to the test group (hydrodynamic transalveolar approach: HTA). The intraoperative and postoperative data, including procedure duration and patient-reported outcome measures (PROMs), were collected during the surgery and up to 1 year post-surgery. Additionally, qualitative assessment of gained bone volumes and implant survival rates was recorded. RESULTS: Twenty-two patients were included in the study. The mean surgical time was significantly longer in the HTA compared to the LW group (48.1 ± 11.2 min vs. 35.2 ± 9.1 min, P = 0.0011). Perforation of the Schneiderian membrane occurred in 2/11 and 5/11 patients in the LW and the HTA group, respectively (P = 0.36). Postoperatively, higher morbidity and consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the LW group. However, self-reported satisfaction with surgical procedures was similar in the two groups. At 1 year, implant survival rates of 80% in the HTA group and 100% in the LW group were recorded (P = 0.12). CONCLUSIONS: Although the new transalveolar approach seems to reduce postoperative morbidity, an increased risk of intraoperative complications compared to the LW approach needs to be considered when choosing a technique. CLINICAL RELEVANCE: Our results provide new insights regarding clinical and radiographic outcomes of HTA and may help further determine indications for its use. TRIAL REGISTRATION: ClinicalTrivals.gov : NCT04499625.