Objectives: Dental implants replacing missing teeth is of a big concern in the maxillary posterior region due to pneumatisation of the maxillary sinus. To overcome this problem, indirect maxillary sinus floor augmentation is the technique of choice. This pilot study compared the outcomes of indirect maxillary sinus lift and simultaneous implant placement with and without melatonin application.

Materials and Methods: 20 patients with missing maxillary molars or premolars were selected to receive 20 dental two-pieces implants simultaneously with indirect maxillary sinus lifting using sinus crestal approach (SCA) kit. These 20 patients were randomly divided into two groups, where group 1 included patients who received local melatonin gel at osteotomy site while group 2 included patients who had no melatonin. Immediate implant stability test was performed using the Osstell Monitor . Patients were recalled for follow up at three, six, and nine months for clinical changes, three and nine months for radiographic evaluation.

Results: All implants were considered successful after nine months of follow up. A high statistically significant difference in implant stability and bone density in group I with local melatonin application (P =0.0005), and both buccal and palatal sides bone density, P = 0.009 & 0.042, respectively.

Conclusions: This pilot study is the first to test the indirect sinus lift technique combined with melatonin gel application and simultaneous implant placement. After nine months of follow up, predictable outcomes are evident in all patients who presented initially with posterior maxilla resorption due to sinus pneumatisation.