Endoscopic-Assisted Versus Conventional Crestal Sinus Lift

Type of study design: A Randomized Clinical Trial Objective of the research: To compare Endoscopic-Assisted Versus Conventional Crestal Sinus Lift; bone grafting will be performed, followed by implant placement. Membrane perforation rates, surgical time, and bone density changes will be evaluated.

Steps of the research in short including the following:

• The inclusion and exclusion criteria for patient selection. Inclusion criteria: Loss of one or more maxillary posterior tooth, Patients age≥21 years, Bone height was 4-7 mm, sufficient inter-arch space and mesio-distal width.

Exclusion criteria Parafunctional habits, Drug or alcohol abuse, uncontrolled systemic diseases that contraindicate implant surgery, pregnant women, Smokers.

• Mention the source of the patients enrolled in the research All patients will be operated on and followed up at the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Egypt.
• A written informed consent form will be signed from the patientis required.
• Description of the methodology. Radiographic assessment involved panoramic X-rays and cone-beam computed tomography (CBCT). CBCT analysis included evaluation of residual bone height, buccopalatal bone width, sinus pathology, bony septa, and precise measurement of Schneiderian membrane thickness at the planned implant sites Group 1(non-endoscopic-guided): Endoscopic evaluation was performed after complete osteotomy preparation and sinus membrane elevation using osteotomes.

Group 2 (Endoscopic-guided): Endoscopic evaluation was conducted after each drilling step, osteotome malleting, and bone graft placement to monitor sinus membrane integrity.

Sample size calculation.

• Randomization in case of RCT. Patients will be divided into two groups based on treatment type using block randomization of block size 4. An independent statistician will generate the random sequence using a computer-generated random number list method by (https://www.randomizer.org/).
• Number of visits \& follow up period. ( 4 visits)

Patients in both groups will be followed up at 24-hours, one, three, six, months postoperatively to assess this parameter:

1. Membrane integrity intraoperative.
2. Surgical intraoperative time.
3. Radiographically, mean bone density will be measured (immediate post-operative and post 6 months CBCT)