Minimal invasive crestal sinus technique using autologous fibrin glue versus sticky bone with simultaneous implant insertion: a prospective study

Introduction
Following tooth extraction, posterior maxilla frequently experiences bone resorption and maxil­lary sinus pneumatization, resulting in resorption of bone with insufficient dimension for adequate dental implants placement.

Objectives
This clinical investigation was performed to assess implant stability and radiographic outcomes using autologous fibrin glue (AFG) against sticky bone combined with crestal sinus lift procedure and simultaneous implant insertion.

Material and methods
The study involved 12 implants in ten patients with residual bone height from 5 to 9 mm, divided into two groups. In group A, AFG was applied for maxillary sinus augmentation, while in group B, sticky bone was used for maxillary sinus augmentation. All patients were followed-up clinically to evaluate implant stability at baseline (T0), third month (T3), and ninth month (T9) as well as radiographically to evaluate residual bone height, implant protrusion, graft apical height, and graft sinus height at same time intervals. Data were analyzed using (IBM SPSS software, version 26.0). P-value ≤ 0.05 was considered statistically significant.

Results
A total of 10 patients (8 females, 2 males) participated in the study, with mean age ± SD of 29.83 ± 3.54 years in group A, and mean age ± SD of 32 ± 3.89 years in group B. At T0, T3, and T9 follow-up, there was a statistical significance within each group (with p < 0.001 in all studied parameters). However, there were no significant differences between both groups, with p = 0.843, 0.296, and 0.451 regarding implant stability, p = 0.221, 0.244, and 0.276 in graft apical height, and p = 0.435, 0.494, and 0.673 regarding graft sinus height, respectively.

Conclusions
AFG can be applied as a non-inferior material during sinus lifting with advantages including fewer complications, easy preparation procedure, less time-consuming, and affordable cost.