Minimally Invasive Sinus Elevation: an Alternative to the Lateral Window?

The advances and successes of implant therapy for posterior maxilla have increased the demand for sinus elevation techniques that are minimally invasive, safe, have short chair time and less morbidity.

Objective:In this preliminary study, we report 6 cases of minimally invasive sinus elevation using either the subantral membrane balloon elevator or the Sinu-lift system with or without simultaneous implant placement on maxillary ridges presenting minimal residual bone height. These are cases that would have been traditionally treated using a Caldwell-Luc approach.

Methods:In 5 cases, we used an inflatable balloon, filled with an iodine contrast media, for gentle membrane elevation through a minimal osteotomy located on the crest of the edentulous ridge. Periapical radiographs were taken throughout the procedure for simultaneous evaluation and monitoring of the membrane elevation. After withdrawal of the device, an allograft material mimicking the volume of the expanded balloon was used to graft the sinus. Implants were simultaneously placed when the residual ridge height was greater or equal to 5 mm. In 1 case, we used the Sinu-lift system with a manually powered drill, which was intended to create an opening in the maxillary alveolar ridge without damaging or rupturing the membrane. An implant was placed successfully concomitant with this procedure.

Results:At 6 months the post operative radiographs show sufficient bone height allowing for succesfull placement of dental implants.

Conclusion: these new, minimally invasive sinus elevation techniques are versatile and predictable, especially when faced with anatomical challenges such as an existing maxillary septum or sinus floor unevenness. They enable the surgeon to avoid using the open lateral window approach, increasing patients' acceptance of the proposed treatment and decreasing dramatically the surgical time and the post surgical pain.