Closed and Direct Sinus Elevation Resonance Frequency Analysis


Resonance frequency analysis (RFA) usage estimation and quantitative comparison of implant stability placed in the lateral part of a higher jaw with atrophy by means of sinus elevation of two kinds: closed sinus elevation (CSE), 1-step and 2-step open sinus elevation (OSE).

Materials and Techniques

Further you will see data gathered from 50 patients aged from 29 to 85. 128 implants were divided among sinus elevation methods depending on the initial bone height. 33 implants were placed by means of CSE for the bones higher than 8mm. 44 implants were placed with the help of 1-step OSE in the bones 3-7.9mm. In the cases when the bone was less than 3mm 2-step OSE was used. 51 implant was placed after the healing period. While RFA was conducted the implant stability quotient (ISQ) was recorded. First it was recorded at the 1st stage, then at the 2nd stage, and finally at the 3rd stage in a year. Statistical analysis took place due to existence of the t-test method and the analysis of variance aiming at estimation of differences in implant stability was made with the help of some other techniques.


ISQ while placement was 70.9 for CSE, 68.9 for OSE, and 72.2 for OSE delayed. These differences were not very great statistically (P= .2). At the 2nd stage ISQ totaled 76.7 for CSE, 77.7 for OSE, and 78.7 for OSE delayed. These differences were not too big as well (P= .3). In comparison to the 1st stage ISQ of the 2nd stage were significant for all the 3 methods (P < .01). ISQ increased at 5.8 for CSE, 8.8 for 1-step OSE, and 6.5 for 2-step OSE.


Now we know that both CSE and 1-step as well as 2-step OSE are good for bone buildup in the lateral area of a higher jaw with atrophy. All the three techniques presuppose osseous integration and show statistical increase of ISQ at the 2nd stage in comparison to the stage of placement. In a case when the method is correctly matched ISQ statistical differences for every stage are absent.


Closed sinus elevation. Osteotome was used for sinus elevation.


Making a hollow leading to sinus.


Placement of bone implant in the hollow.


ISQ measuring.


ISQ while implant placement and fixation. ISQ was measured at the 1st and 2nd stages for the implants placed by means of CSE, OSE, and OSE delayed. A standard error as for the medium one (bars) and statistically significant differences (asterix) are shown. ISQ, implant stability quotient; CSE, closed sinus elevation; OSE, open sinus elevation; OSE delayed, open sinus elevation with implant placement postponed.

Sarav Patel and David Lee contributed equally to this work.