الفهرس 
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Abstract
The main objective of this study was to see how the minimally invasive hydrodynamic piezoelectric internal sinus elevation procedure worked with or without bone grafting and simultaneous implant placement, and how it affected clinical outcomes. Together, they were assessing the osteotomes technique.
Participants were chosen from the Alexandria University Teaching Hospital’s outpatient clinic and operated on in the Faculty of Dentistry’s Oral and Maxillofacial Surgery Department.
This is a randomized-controlled study. The study was carried out on thirty maxillary sinuses that matched the inclusion criteria.
Application of a hydrodynamic Piezoelectric internal lifting kit for sinus elevation without bone grafting and simultaneous implant insertion in Study group A (n=10)
Application of a hydrodynamic Piezoelectric internal lifting kit for sinus elevation with bone grafting and simultaneous implant in Study group B (n=10)
Elevation of the maxillary sinus floor with simultaneous implant implantation using the usual (crestal) approach in Control group C. (n=10)
Clinical results
The subsequent clinical parameters were followed postoperatively at the 2nd and 7th day intervals; concerning surgical edema, pain and edema and there was a good significant difference p<0.05* between the piezoelectric lifting procedure and the osteotomes technique.
Regarding the ISQ measurements, the difference was only between the periods postoperatively; immediate and after 6 months which revealed an appropriate significancy, but not between the groups as all of them revealed good implant stability.
Radiographic findings
Piezoelectric sinus lift revealed good quality of significant difference p<0.05* in the bone height gained after the Schneiderian membrane elevation compared to the conventional osteotomes as well as bone density. The conflicts among the two study groups and the other control group regarding the marginal bone height (lost) were confirmed to be statistically significant.