Graft - Less Sinus Lifting Using Titanium Mesh As A Space Maintainer: A Histomorphometric and Radiographical Study

Aim: This study aims to evaluate the effectiveness of graft-less sinus lift procedure by using a titanium mesh as a space maintainer after membrane elevation compared to the standard sinus lift using xenograft mixed with advanced platelet rich fibrin plus. Material and Methods: This study included 16 patients who needed a two-stage external sinus lift. Patients were randomly allocated to two groups, the first received conventional sinus lift using xenograft mixed with advanced platelet rich fibrin plus (A-PRF+) as grafting material (control group), while the second group received graft-less sinus lift by using a fixed titanium mesh as a new sinus floor which serve as a space maintainer (Test group). Patients were evaluated radiographically using cone beam CT immediately after surgery and after 9 months. Core biopsies were collected at implant placement for histomorphometric evaluation. Results: The mean bone gain was 8.99mm and 4.14mm in the control and test groups respectively while the new bone volume was 1.19cc and 0.49cc in the control and test groups respectively. The differences between groups were statistically significant. Histomorphometric data revealed statistically significant higher bone to soft tissue ratio (70.3/%) in the control group compared to the test group (46.7%). Conclusion: With in the limitation of this study the use of Titanium mesh as a space maintainer in graft-less sinus lift resulted in sufficient bone to place implants after 9 months healing, however the bone height and volume were statically less than the control group