AzTrials
AzTrials

Severe Atrophy of the Edentulous MaxillaNCT06105489

"Tunnel" Flap vs Trapezoidal Flap for Lateral Sinus Lift

A study testing Lateral Sinus Lift using tunnel flap technique and Lateral Sinus Lift using crestal incision flap in people with Severe Atrophy of the Edentulous Maxilla, run by Studio Dentistico Associato Sivolella at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

The goal of this clinical trial is to evaluate the efficacy of the lateral sinus lift procedure using the tunnel technique flap in comparison to the traditional lateral sinus lift in partially or totally edentulous patients with loss of teeth in the maxillary premolar or molar areas and severe alveolar atrophy. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Severe Atrophy of the Edentulous Maxilla
What is being tested?
Lateral Sinus Lift using tunnel flap technique and Lateral Sinus Lift using crestal incision flap
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
1 siteItaly
Study dates
21 Oct 2022to 21 Oct 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • edentulous or partly edentulous patients with a unilateral loss of teeth in the maxillary premolar or molar areas
  • severe alveolar atrophy and a residual severe alveolar ridge height up to 3 mm

Who cannot join

  • severe illness
  • head and neck radiation therapy
  • chemotherapy
  • antiresorptive therapy
  • uncontrolled diabetes
  • uncontrolled periodontal disease
Show all 9Show fewer
  • smoking >10 cigarettes per day
  • facial or neck inflammatory or oncologic diseases
  • obliteration of sinus ostium and osteomeatal complex

Trial locations and contacts

1 site in 1 country.

Stefano Sivolella, DDS, PhD contact

0039 049 652821

stefano.sivolella@unipd.it

Dario Azeglio Castagna contact

00393498550779

dario.castagna@virgilio.it

Italy1 site, 1 recruiting
  • Studio Dentistico Associato Graiff e Sivolella

    Padova, 35127

    Stefano Sivolella, DDS, PhD, 0039 049 652821, stefano.sivolella@unipd.it

    Stefano Sivolella, DDS, PhD

    Recruiting

Other trials in Italy

About this study

Official title: "Tunnel" Flap vs Trapezoidal Flap for Lateral Sinus Lift: A Prospective Randomized Study

The goal of this clinical trial is to evaluate the efficacy of the lateral sinus lift procedure using the tunnel technique flap in comparison to the traditional lateral sinus lift in partially or totally edentulous patients with loss of teeth in the maxillary premolar or molar areas and severe alveolar atrophy. The primary questions it aims to answer are:

  1. Is the tunnel flap technique more suitable for lateral sinus lift than the trapezoidal flap technique in terms of post-operative symptoms?
  2. Is the tunnel technique safer and more effective than the trapezoidal flap technique in terms of complication rate and the effectiveness of bone grafting?
Read more

Participants will undergo the lateral sinus lift procedure using the tunnel technique, which involves making a vertical anterior incision. Patients will receive follow-up care, including phone contact the day after the procedure to detect any issues, and they will keep a diary during the week after surgery to record visual analog scale (VAS) pain values and analgesics taken. Follow-up surgical visits will be scheduled for suture removal and at 30 days after suture removal. After 6 months, dental implants will be inserted, and prosthetic rehabilitation will take place 6 months later. Implants will be monitored for up to 12 months after prosthetic rehabilitation.

Researchers will compare the outcomes of tunnel flap technique lateral sinus lift with the trapezoidal flap sinus lift.

Being tested
Lateral Sinus Lift using tunnel flap technique, Lateral Sinus Lift using crestal incision flap
Keywords
Lateral sinus lift, Tunnel technique, Dental Implant, Patient Reported Outcome Measures, Bone Regeneration, Flap Design, Histology, Heterologous bone, Cone Beam Computed Tomography

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lateral Sinus Lift using tunnel flap techniqueProcedure or surgery

    The surgical procedure will involve the following steps:

    • A single vertical anterior incision will be made, at least 10 mm mesially to the expected outline of the bony window.
    • A full-thickness flap will be carefully elevated to expose the lateral wall of the maxillary sinus.
    • A trap door will be created in the lateral wall of the maxillary sinus using either a dedicated piezosurgical insert or a straight handpiece with a 3mm round diamond bur.
    • The door will be removed.
    • The sinus membrane will be gently elevated using various-shaped curettes until it becomes completely detached from the lateral, inferior, and medial walls of the sinus.
    • The maxillary sinus will be filled with a heterologous bone graft with a well-documented efficacy.
    • The flaps will be meticulously sutured.
  • Lateral Sinus Lift using crestal incision flapProcedure or surgery

    The surgical procedure will involve the following steps:

    • A horizontal incision is made on the top of the alveolar ridge, along with two additional releasing incisions in the mesial and distal regions.
    • A full-thickness flap will be carefully elevated to expose the lateral wall of the maxillary sinus.
    • A trap door will be created in the lateral wall of the maxillary sinus using either a dedicated piezosurgical insert or a straight handpiece with a 3mm round diamond bur.
    • The door will be removed.
    • The sinus membrane will be gently elevated using various-shaped curettes until it becomes completely detached from the lateral, inferior, and medial walls of the sinus.
    • The maxillary sinus will be filled with a heterologous bone graft with a well-documented efficacy.
    • The flaps will be meticulously sutured.
Study groups in NCT06105489
Study groupRoleWhat they receive
Tunnel flap designExperimentalParticipants will undergo a lateral sinus lift procedure in which a single vertical anterior incision will be made at least 10 mm mesially to the expected outline of the bony window.
Receives: Procedure: Lateral Sinus Lift using tunnel flap technique
Trapezioidal flap designActive comparatorParticipants will undergo a lateral sinus lift procedure. The incision will be made horizontally on the top of the alveolar ridge, with two additional releasing incisions in the mesial and distal regions.
Receives: Procedure: Lateral Sinus Lift using crestal incision flap

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain and discomfort on VAS scale at the 4th postoperative day

    Participants will record the subjective post-operative pain/discomfort on a daily VAS score (0 to 10) for the first 7 days, at the same time each day, on a specific form. The VAS is a horizontal ruler 10 cm long with the left end (0 cm) indicating "no pain/discomfort at all" and the right limit (10 cm) indicating "the worst pain imaginable. Patients will be also asked to record the need for analgesics (including type and quantity).

    Measured: First week after sinus lift procedure

Secondary outcomes (4)
  1. Times for surgical procedure

    Surgical intervention duration (minutes) recorded from incision to the last suture (T1). Times for sinus mucosa elevation (T2) and for sinus filling (T3) will be measured as well.

    Measured: During sinus lift procedure

  2. Soft tissue healing after sinus lift

    Soft tissue healing will be evaluated using the scoring reported by Lin SL et al., at two timepoints: at suture removal and at 30 days after suture removal control.

    Assessments of wound healing will include 6 scoring categories, namely erythema, exudate, epithelialization, mucosa color, wound contour, and distortion of mucosa. Each category is scored on a 3-point scale (0, 1, or 2) and a total score from 0 to 3 represents good healing, a score from 4 to 6 represents satisfactory healing, a score from 7 to 9 represents disturbance of healing, and a score from 10 to 12 represents poor healing

    Measured: 10 days and 40 days after sinus lift procedure

  3. Sinus lift related complications

    Possible complications will be evaluated at various timepoints. During the surgical procedure through direct observation (bleeding, sinus membrane perforation, infraorbital nerve injury, perforation of the flap). The day after surgery through a telephone call to the patient (bleeding, flap dehiscence, hematoma, pain). At suture removal control after 10 +/- days after surgery (pain, infections, sinusitis, bone graft displacement, neuropathy, wound dehiscence). At 30 days after suture removal control (pain, infections, sinusitis, bone graft displacement, neuropathy).

    Measured: During sinus lift procedure, 1, 10 and 40 days from procedure.

  4. Graft healing after a 6 months period

    A CBCT of the grafted area finalized to implants insertion planning will be taken after 6 months from the sinus lift. The parameters evaluated will be the final alveolar bone graft height calculated in correspondence of a line passing through the centre of the previous bone window; the presence of the contact between the bone graft and the medial or nasal wall of the sinus cavity; the regular distribution of the graft, intended as the presence of voids or displacements. Moreover a biopsy will be taken during implants insertion by means of a trefine.

    Measured: 6 months after implant procedure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Oct 2023
  2. Study start21 Oct 2022
  3. Primary completion21 Oct 2024 (estimated)
  4. Study completion21 Oct 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be assigned to one of two study arms, a test arm and a control arm, for the entire duration of the study.
Masking
None (open label)
Enrolment
36 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06105489
Sponsor's protocol ID
20464
Status last verified
Oct 2023
First submitted
8 Oct 2023
Last updated
27 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980 Aug;38(8):613-6. No abstract available.

    PubMed 6993637
  • Stacchi C, Lombardi T, Ottonelli R, Berton F, Perinetti G, Traini T. New bone formation after transcrestal sinus floor elevation was influenced by sinus cavity dimensions: A prospective histologic and histomorphometric study. Clin Oral Implants Res. 2018 May;29(5):465-479. doi: 10.1111/clr.13144. Epub 2018 Mar 23.

    PubMed 29569763
  • Spinato S, Bernardello F, Galindo-Moreno P, Zaffe D. Maxillary sinus augmentation by crestal access: a retrospective study on cavity size and outcome correlation. Clin Oral Implants Res. 2015 Dec;26(12):1375-82. doi: 10.1111/clr.12477. Epub 2014 Sep 5.

    PubMed 25196695
  • Soardi CM, Spinato S, Zaffe D, Wang HL. Atrophic maxillary floor augmentation by mineralized human bone allograft in sinuses of different size: an histologic and histomorphometric analysis. Clin Oral Implants Res. 2011 May;22(5):560-6. doi: 10.1111/j.1600-0501.2010.02034.x. Epub 2010 Dec 9.

    PubMed 21143532
  • Stacchi C, Spinato S, Lombardi T, Bernardello F, Bertoldi C, Zaffe D, Nevins M. Minimally Invasive Management of Implant-Supported Rehabilitation in the Posterior Maxilla, Part II. Surgical Techniques and Decision Tree. Int J Periodontics Restorative Dent. 2020 May/Jun;40(3):e95-e102. doi: 10.11607/prd.4498.

    PubMed 32233185
  • Moy PK, Lundgren S, Holmes RE. Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg. 1993 Aug;51(8):857-62. doi: 10.1016/s0278-2391(10)80103-x.

    PubMed 8393101
  • Browaeys H, Bouvry P, De Bruyn H. A literature review on biomaterials in sinus augmentation procedures. Clin Implant Dent Relat Res. 2007 Sep;9(3):166-77. doi: 10.1111/j.1708-8208.2007.00050.x.

    PubMed 17716261
  • Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol. 2008 Sep;35(8 Suppl):216-40. doi: 10.1111/j.1600-051X.2008.01272.x.

    PubMed 18724852
  • Kao SY, Lui MT, Cheng DH, Chen TW. Lateral trap-door window approach with maxillary sinus membrane lifting for dental implant placement in atrophied edentulous alveolar ridge. J Chin Med Assoc. 2015 Feb;78(2):85-8. doi: 10.1016/j.jcma.2014.05.016. Epub 2014 Oct 3.

    PubMed 25287252
  • Silva LD, de Lima VN, Faverani LP, de Mendonca MR, Okamoto R, Pellizzer EP. Maxillary sinus lift surgery-with or without graft material? A systematic review. Int J Oral Maxillofac Surg. 2016 Dec;45(12):1570-1576. doi: 10.1016/j.ijom.2016.09.023. Epub 2016 Oct 17.

    PubMed 27765427
  • Danesh-Sani SA, Engebretson SP, Janal MN. Histomorphometric results of different grafting materials and effect of healing time on bone maturation after sinus floor augmentation: a systematic review and meta-analysis. J Periodontal Res. 2017 Jun;52(3):301-312. doi: 10.1111/jre.12402. Epub 2016 Aug 18.

    PubMed 27534916
  • Stacchi C, Andolsek F, Berton F, Perinetti G, Navarra CO, Di Lenarda R. Intraoperative Complications During Sinus Floor Elevation with Lateral Approach: A Systematic Review. Int J Oral Maxillofac Implants. 2017 May/Jun;32(3):e107-e118. doi: 10.11607/jomi.4884.

    PubMed 28494033
  • Testori T, Weinstein T, Taschieri S, Wallace SS. Risk factors in lateral window sinus elevation surgery. Periodontol 2000. 2019 Oct;81(1):91-123. doi: 10.1111/prd.12286.

    PubMed 31407430
  • Scarano A, Lorusso F, Arcangelo M, D'Arcangelo C, Celletti R, de Oliveira PS. Lateral Sinus Floor Elevation Performed with Trapezoidal and Modified Triangular Flap Designs: A Randomized Pilot Study of Post-Operative Pain Using Thermal Infrared Imaging. Int J Environ Res Public Health. 2018 Jun 16;15(6):1277. doi: 10.3390/ijerph15061277.

    PubMed 29914159
  • Rothstein SS, Paris DA, Zacek MP. Use of hydroxylapatite for the augmentation of deficient alveolar ridges. J Oral Maxillofac Surg. 1984 Apr;42(4):224-30. doi: 10.1016/0278-2391(84)90453-1.

    PubMed 6323657

Questions about this trial

What is this clinical trial studying?

A study testing Lateral Sinus Lift using tunnel flap technique and Lateral Sinus Lift using crestal incision flap in people with Severe Atrophy of the Edentulous Maxilla, run by Studio Dentistico Associato Sivolella at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Stefano Sivolella, DDS, PhD (0039 049 652821, stefano.sivolella@unipd.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain and discomfort on VAS scale at the 4th postoperative day (time frame: First week after sinus lift procedure). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06105489, which also lists 22 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Oct 2023; AzTrials last refreshed its copy on 6 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in