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J Clin Periodontol. 2010 Aug 1;37(8):777-87. doi: 10.1111/j.1600-051X.2010.01577.x. Epub 2010 Jun 10.

An economic evaluation of different sinus lift techniques.

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  • 1Department of Conservative Dentistry, University of Heidelberg, Heidelberg, Germany.



To identify the most cost-effective approach to sinus lifting on the basis of currently available evidence.


We incorporate the costs and clinical outcomes of nine different sinus lift techniques within a decision tree model in which costs are based on insurance regulations in Germany and health outcomes follow two recent meta-analyses. The most cost-effective treatment option is identified on the basis of the maximum net benefit criterion. Uncertainties regarding health outcomes are incorporated via probabilistic sensitivity analysis based on Monte-Carlo simulation.


When there are no financial restrictions, the optimum treatment strategy is the lateral approach with autogenous particulate bone and a resorbable membrane. When, however, monetary resources for sinus-floor elevation are scarce, the most cost-effective option is the transalveolar technique without bone grafting. Only if relatively high costs can be afforded or if initial bone height at implant site is below 5 mm is the maximum net benefit achieved by lateral approaches.


On the basis of currently available evidence, the transalveolar technique is advisable when monetary resources for sinus-floor elevation are scarce and initial bone height is sufficiently high. Lateral approaches are primarily recommended for lower pre-operative bone heights.

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