When Hydrophilia Meets the Maxilla: What a New Study Reveals About Implant Stability Following Transcrestal Sinus Lift

Abstract

When working in the posterior maxilla, we all know the drill — and not just the surgical one.
Reduced bone density, limited residual height, and sinus proximity often make even straightforward cases feel like high-stakes precision work.
Over the years, techniques like the transcrestal sinus lift have offered predictable, minimally invasive routes to implant placement in these challenging areas. But as implant surface technologies evolve, one key question continues to stir debate:

Does a higher super-hydrophilicsurface of implant actually enhance stability in low-density bone?

A recent 2025 case–control study by Baldi et al., published in Prosthesis, set out to answer exactly that — comparing Alpha-Bio Tec’s MultiNeO™ NH CS (nano-hydrophilic) and MultiNeO™ CS (moderately rough) implants in posterior maxilla rehabilitations combined with a crestal sinus lift.   

Setting the Stage: Why Surface Matters 

Implant success has never depended on one factor alone. Bone quality, surgical protocol, and the macrogeometry of the implant all play their roles — but the surface remains one of the most critical players in osseointegration.

Microrough surfaces have long been shown to enhance protein adsorption and early cellular attachment, accelerating bone formation at the implant–bone interface. Yet, in recent years, surface wettability — the ability of a surface to attract and interact with fluids — has captured clinicians’ attention.

Super-hydrophilicsurfaces, existing on implant surface, are characterized by low contact angle with water (wettability) (<90°) , promote faster protein adsorption and cell adhesion. Theoretically, this means better early bone response — particularly useful in low-density maxillary bone, where healing and integration are more delicate.

Still, clinical results have been mixed. Some preclinical studies report enhanced bone deposition and stability with super-hydrophilicsurfaces, while others show little to no difference compared with conventional rough surfaces.

This study brings new data — using Alpha-Bio Tec’s latest generation of super-super-hydrophilicimplants — to this ongoing discussion.

The Study at a Glance

• Design: Single-center, 6-month case–control clinical trial
• Participants: 35 patients receiving single implants in the posterior maxilla with simultaneous transcrestal sinus lift (closed sinus)
• Groups:
  • • Test group (TG): MultiNeO™ NH CS (super-hydrophilic nano-scale surface roughness)
    • Control group (CG): MultiNeO™ CS (moderately rough surface)
• Surgical approach: Fully guided trans-crestal osteotomy with collagen sponge graft (OSSIX™ Bone Graft)
• Assessment method: Implant Stability Quotient (ISQ) measured bucco-lingually and mesio-distally at placement (t0), 4 months (t4), and 6 months (t6).

All surgeries were performed by a single experienced clinician under standardized conditions.

What They Found  

Across both groups, implant stability increased consistently over time — a reassuring sign for anyone using these systems in sinus lift cases.

• Mean bucco-lingual ISQ rose from 69.45 at insertion to 75.21 at 6 months.
• Mean mesio-distal ISQ rose from 67.54 to 75.67.

Statistically, no significant differences were found between the two surface types over the 6-month period. However, a closer look reveals subtle trends worth noting:

• The super-hydrophilic MultiNeO™ NH (Nina) CS (Conical Standard) group showed a significant increase in bucco-lingual ISQ between 4 and 6 months.
• The moderately rough MultiNeO™ CS group showed a significant increase in mesio-distal ISQ between baseline and 6 months.

In simple terms — both performed well, and both got more stable with time. But their “stability curves” may differ slightly in when and how they peak.

Importantly, no biological or technical complications were recorded in either group, and only one implant (from the control group) failed before the 4-month mark.

What Does This Mean for Everyday Clinical Work?  

For clinicians, these findings support a practical takeaway: both super-hydrophilic and moderately rough surfaces from Alpha-Bio Tec can safely achieve stable integration in challenging maxillary sites when paired with a controlled transcrestal lift and guided surgery.

The lack of statistically significant differences doesn’t imply that surface properties don’t matter — but rather that other clinical factors (surgical precision, bone density, patient health) may outweigh surface chemistry in determining short-term stability.

However, the distinct ISQ growth patterns observed hint that the super-hydrophilic surface might promote a steadier late-stage stability gain, possibly linked to enhanced biological interaction during bone remodeling.That’s clinically meaningful for dentists considering earlier loading protocols or complex rehabilitations in low-density bone. 

Two Clinical Takeaways for Implantologists 

1. Guided crestal sinus lift remains a safe and effective approach when performed with controlled torque and verified membrane elevation.
   Both implant surfaces in this study integrated successfully without complications.

Implant surface chemistry may influence stability timing, not just magnitude.
Super-hydrophilicsurfaces like MultiNeO™ NH CS may show their advantage in later healing phases or under early loading scenarios. 

Alpha-Bio Tec’s Perspective

Alpha-Bio Tec’s ongoing research collaborations and clinical studies, like this one, are part of a broader commitment to evidence-based innovation. Both MultiNeO™ CS and MultiNeO™ NH CS share identical macrodesigns — built for efficient, guided workflows — while offering clinicians the flexibility to choose the surface chemistry best suited to each patient’s biological context.

By supporting studies led by independent research teams, Alpha-Bio Tec aims to ensure that its products are validated not just by engineering excellence, but by real-world data from practicing clinicians.

Final Thoughts

The posterior maxilla remains one of implantology’s most demanding frontiers — but this study reinforces a reassuring truth: surface innovation is evolving in the right direction.

Both MultiNeO™ CS and MultiNeO™ NH CS demonstrated increasing stability, reliable osseointegration, and uneventful healing at 6 months — a clinical endorsement of Alpha-Bio Tec’s design philosophy: to blend biological compatibility with surgical simplicity.

While hydrophilia didn’t deliver a dramatic leap in this short-term trial, its steady late-phase stability gain keeps it squarely in the spotlight for ongoing research — particularly in early loading and compromised bone cases.

Read full case control study here.
Learn more about the MultiNeO™ Implant and NiNA™ Technology here: Alpha-Bio Tec Academy.