Modified Disk-Up Sinus Reamer for Sinus Floor Elevation and Simultaneous Implant Placement: An Animal Study with Miniature Pigs.

Objective: The disk-up sinus reamer (DSR) is a modified instrument used to elevate the maxillary sinus floor. This study aimed to compare the effects of modified DSR sinus floor elevation (DSFE) with osteotome sinus floor elevation (OSFE), both with simultaneous implant placement. Methods: Twelve miniature pigs were treated with DSFE on one side and OSFE on the other. Implants 9 mm in length were placed in six pigs without grafting, while implants 11 mm in length were placed in the other six pigs with grafting. After submerged healing for 3 months, vertical bone gain (VBG), general and histological observation, and bone contact ratio (BCR) were analyzed. Results: The mean maxillary residual bone height (RBH) when implants were placed was 6.45 ± 0.36 mm. In the no-grafting group, DSFE and OSFE had a similar VBG after 3 months. The grafting group with DSFE recorded a significantly higher VBG (VBG0: 7.83 ± 0.44 mm, VBG1: 7.54 ± 0.40 mm) than the graft group with OSFE (VBG0: 5.45 ± 0.56 mm, VBG1: 4.34 ± 2.15 mm) (p < 0.05). One implant became loose and the sinus mucosa of three pigs appeared metallic in color on the control side (OSFE). Conclusions: The effect of OSFE and DSFE is similar when there is no need for grafting. DSFE seems a better alternative method for sinus floor elevation with grafting when more VBG is needed.