Clinical, radiographic and histomorphometry evaluation of the osteogenic potential of Schneiderian membrane after graftless maxillary sinus augmentation: a randomized controlled clinical trial

Background To evaluate the osteogenic potential of the Schneiderian membrane following sinus floor elevation using bioabsorbable screws as space maintainers, without the use of graft material. Methods Fourteen patients with severely atrophic posterior maxilla were enrolled in the current study. All patients underwent maxillary sinus augmentation via a lateral window approach. Patients were randomly allocated into two groups. In the control group, the sinus cavity was filled with xenograft material. In the intervention group, the Schneiderian membrane was elevated and stabilized using bioabsorbable screws, with no graft material used to fill the space. Results Cone beam computed tomography (CBCT) of all patients revealed radiographic bone height improvement in both groups, with the control group showing a greater mean increase. Histomorphometric analysis revealed a tendency toward higher new bone formation in the intervention group, though the difference did not reach statistical significance. Conclusion Bioabsorbable screws may serve as effective space maintainers for graftless sinus elevation, allowing for spontaneous bone regeneration beneath the Schneiderian membrane. While conventional grafting with xenograft remains predictable, the bioresorbable screws-supported graftless approach offers a promising alternative in sinus floor elevation. Trial registration This study protocol was retrospectively registered on the trial registry “Clinical trials.gov PRS”. ClinicalTrials.gov ID is NCT06766292. Registered on January 5th, 2025.