Avoiding sinus floor elevation by placing a palatally angled implant: a morphological study using cross-sectional analysis determined by CBCT

Abstract

Backgrounds: Tooth loss in the posterior maxilla often necessitates dental implant placement, but the maxillary sinus anatomy poses challenges, especially during sinus floor elevation. Mesially angled implants are an alternative for total edentulism, but for single tooth deficiencies, palatally angled implants may offer a solution. This study evaluates the prevalence of avoiding sinus floor elevation by placing palatally angled implants in cases with a single missing tooth. Methods: A retrospective study at Ahmet Keleşoğlu Faculty of Dentistry involved 100 participants with a single missing tooth and prior CBCT scans. Virtual implants were placed using OnDemand3D (version 1.0.7462) software. On CBCT sections, implants were angled palatally to avoid sinus or nasal cavity perforation. Statistical analysis was conducted using R and MedCalc (version 4.3.2) software. Results: Of the participants (60% female, average age 50.45), 76 edentulous regions required sinus elevation. The implant placeability rates varied across zones (second molar: 39.3%, first molar: 63.1%, second premolar: 78.5%). Implant placement at a palatal angle was significantly higher in the second premolar and first molar regions. Statistically significant differences were observed in the implant placeability between regions. Conclusions: This study supports the feasibility of avoiding sinus floor elevation through palatally angled implants in specific cases, reducing the associated complications.