Using Chin Bone Rings for Sinus Lifting and Dental Implants in One Surgery

NCT07619846 | Not Yet Recruiting

• 2 other identifiers: UDDS-2026-OralMaxillofacial-01DN-28102025-542
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluates the Bone Ring Technique, a single stage procedure that combines external sinus floor elevation and dental implant placement using an autogenous bone ring harvested from the chin. Ten patients with residual alveolar bone height ≤4 mm in the posterior maxilla will be enrolled. Implant stability (ISQ), vertical bone gain, peri implant bone density, and implant survival will be assessed over 6 months. The aim is to reduce treatment time and surgical interventions compared to traditional two stage approaches.

Conditions

Severe Alveolar Bone Atrophy of the Posterior Maxilla With Residual Bone Height ≤4 mm

Keywords

Bone Ring Technique; Maxillary Sinus Floor Elevation; Dental Implant

Outcome Measures

Primary Outcomes (1)

• Implant Stability Quotient (ISQ).

  Measured by resonance frequency analysis with MEGA ISQ II (MegaGen, Korea), Four readings per implant (mesial, distal, buccal, lingual); mean value reported

  Immediately after implant placement (baseline) and 6 months post_surgery (before prosthetic loading).

Secondary Outcomes (3)

• Vertical Bone Gain (mm)

  at preoperative, 1 week post_surgery , 6 months post_surgery

• Peri implant Bone Density (gray values)

  at preoperative, 1 week post_surgery , 6 months post_surgery

• Implant Survival & Success

  6 months post_surgery

Study Arms (1)

Bone Ring Technique (BRT)

EXPERIMENTAL

Eligible patients with posterior maxillary atrophy (RBH ≤4 mm) will undergo a single surgical session. Preoperatively, CBCT will be performed. Under local anesthesia, the surgeon will harvest an autogenous bone ring from the chin (mandibular symphysis) using trephine burs. A lateral window will be created in the maxillary sinus wall using a straight handpiece with a diamond round bur. The sinus membrane will be elevated, and the bone ring will be placed into the sinus. A dental implant (ICX) will be inserted through the ring into the residual ridge. The defect will be filled with xenograft particles and covered with a collagen membrane. Sutures will be removed at 7-10 days. Patients will be followed for 6 months with clinical and CBCT evaluations.

Procedure: Bone Ring Technique (BRT)

Interventions

Bone Ring Technique (BRT) PROCEDURE

The Bone Ring Technique (BRT) is a one-stage surgical procedure that combines external maxillary sinus floor elevation with simultaneous dental implant placement. An autogenous bone ring is harvested from the mandibular symphysis using trephine burs. The sinus membrane is elevated via a lateral window approach created with a straight handpiece and diamond round bur. The bone ring is then placed into the sinus cavity, and a dental implant is inserted through the ring into the residual alveolar bone. The surgical site is augmented with xenograft particles and covered with a collagen membrane.

Bone Ring Technique (BRT)

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Need for dental implant in posterior maxilla (premolar/molar).
• Residual alveolar bone height ≤4 mm on preoperative CBCT.
• Age ≥18 years.
• Controlled systemic health.
• Able to comply with procedures and follow up.
• Good oral hygiene.
• Signed written informed consent.

You may not qualify if:

• Uncontrolled systemic disease.
• Head/neck radiotherapy.
• Bisphosphonate therapy \>3 years.
• Autoimmune disease affecting healing.
• Pregnancy/lactation.
• Active maxillary sinus pathology (sinusitis, cysts, polyps, tumours).
• Heavy smoking (\>10 cigarettes/day).
• Severe bruxism.

Sponsors & Collaborators

• Damascus University: lead

Study Sites (1)

Oral and Maxillofacial Surgery Hospital, Faculty of Dentistry, Damascus University, Mezzeh Highway, Damascus, Syria

Damascus, Governorate, 4671, Syria

Location

Related Publications (10)

• Alchalabi NJ, Merza AM, Issa SA. Using Carnoy's Solution in Treatment of Keratocystic Odontogenic Tumor. Ann Maxillofac Surg. 2017 Jan-Jun;7(1):51-56. doi: 10.4103/ams.ams_127_16.

  PMID: 28713736 BACKGROUND

• Giesenhagen B, Martin N, Donkiewicz P, Peric Kacarevic Z, Smeets R, Jung O, Schnettler R, Barbeck M. Vertical bone augmentation in a single-tooth gap with an allogenic bone ring: Clinical considerations. J Esthet Restor Dent. 2018 Nov;30(6):480-483. doi: 10.1111/jerd.12392. Epub 2018 Aug 2.

  PMID: 30070751 BACKGROUND

• Giesenhagen B, Martin N, Jung O, Barbeck M. Bone Augmentation and Simultaneous Implant Placement with Allogenic Bone Rings and Analysis of Its Purification Success. Materials (Basel). 2019 Apr 19;12(8):1291. doi: 10.3390/ma12081291.

  PMID: 31010149 BACKGROUND

• Sleman N, Khalil A. Autogenous bone ring augmentation and simultaneous implant placement in the atrophic posterior maxilla: A case report. Int J Surg Case Rep. 2025 Feb;127:110970. doi: 10.1016/j.ijscr.2025.110970. Epub 2025 Jan 27.

  PMID: 39879710 BACKGROUND

• Nunes MP, Nunes LFP, Filho DPN, Pinho RCM, Cimoes R. Bone Ring Technique for the Treatment of Vertical and Horizontal Bone Defects with Immediate Implants: A Report of Two Cases. Int J Periodontics Restorative Dent. 2021 May-Jun;41(3):413-421. doi: 10.11607/prd.4401.

  PMID: 34076639 BACKGROUND

• Nunes MP, Nunes LFP, Ribeiro JCB, Mourao Pinho RC, Cimoes R. Maxillary Sinus Elevation Using the Bone Ring Technique with Immediate Implantation: A Case Report. Int J Periodontics Restorative Dent. 2022 Jul-Aug;42(4):525-533. doi: 10.11607/prd.4746.

  PMID: 35830319 BACKGROUND

• Arab HR, Moeintaghavi A, Shiezadeh F, Nezhad MH. Crestal Sinus Floor Elevation with Autogenous Press-Fit Dowel Bone Harvested Using Trephine Drills: A New Method. J Long Term Eff Med Implants. 2018;28(3):209-214. doi: 10.1615/JLongTermEffMedImplants.2018017280.

  PMID: 30806279 BACKGROUND

• Saez-Alcaide LM, Brinkmann JC, Sanchez-Labrador L, Perez-Gonzalez F, Molinero-Mourelle P, Lopez-Quiles J. Effectiveness of the bone ring technique and simultaneous implant placement for vertical ridge augmentation: a systematic review. Int J Implant Dent. 2020 Dec 12;6(1):82. doi: 10.1186/s40729-020-00280-0.

  PMID: 33313968 BACKGROUND

• Flanagan D. Cylindrical Ringbone Allograft to Restore Atrophic Implant Sites: A Pilot Study. J Oral Implantol. 2016 Apr;42(2):159-63. doi: 10.1563/aaid-joi-D-15-00052. Epub 2015 Sep 8.

  PMID: 26348838 BACKGROUND

• Omara M, Abdelwahed N, Ahmed M, Hindy M. Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant. Int J Oral Maxillofac Surg. 2016 Apr;45(4):535-44. doi: 10.1016/j.ijom.2015.11.001. Epub 2015 Nov 28.

  PMID: 26644216 BACKGROUND

Study Officials

• Khaldoun Darwich, professor of OMFS

  Damascus University Syria

  STUDY DIRECTOR

Central Study Contacts

Adel Alassaf, Resident &MSc candidate in OMF

CONTACT

+963 949038706; sx19adel@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Prospective, single-arm case series. All eligible patients with residual alveolar bone height ≤4 mm in the posterior maxilla will receive the same intervention: one-stage external maxillary sinus lifting using the autogenous Bone Ring Technique with simultaneous dental implant placement. Participants will be followed for 6 months post-surgery. No comparator group is included.

Study Record Dates

• First Submitted: May 26, 2026
• First Posted: June 2, 2026
• Study Start: May 31, 2026
• Primary Completion (Estimated): February 21, 2027
• Study Completion (Estimated): March 21, 2027
• Last Updated: June 4, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Starting 6 months after publication of primary results for a period of 3 years.
• Access Criteria: Requests for data access should be directed to the principal investigator (Adel Alassaf) via adel96.alassaf@damascusuniversity.edu.sy. Access will be granted to qualified researchers whose proposed use of the data has been approved by an independent review committee. Requesters will need to sign a Data Use Agreement (DUA) and ensure IRB approval or exemption for their proposed research.

Locations

SY (1)