Peter A. W. H. Kessler

Background Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials. Objectives This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation. Methods The study group consisted of patients who had received a graftless sinus lift procedure in a split‐mouth design and was compared to patients with maxillary implant‐supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction. Results Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant‐retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for ‘prosthesis’, ‘appearance of prostheses’, ‘speech’ and ‘mastication and eating’. Conclusions Patients with implant‐supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant‐retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical‐technical aspects and patient's preferences.