Lateral window design for sinus lift procedure

Abstract

Introduction. The sinus lift procedure, followed by immediate or delayed implant placement, is a common way of managing severe bone atrophy of the edentulous posterior region of the maxilla. A variety of osteotomy instruments such as rotary handpieces, piezosurgery devices and lasers, as well as methods of sinus mucosa elevation such as using curettes, balloon-assisted or hydraulic technique are available nowadays. However some of these devices are highly expensive or require special training. This report’s purpose is to display an example of an efficient, safe and affordable technique of lateral sinus lift window preparation. Case presentation. A 45 years old female patient with partial edentation of maxilla was admitted for implant treatment. During radiological examination, insufficient vertical bone height was determined, therefore lateral sinus lift was decided to be performed. The surgery was done under local anesthesia. After the traditional flap mobilization, an elliptical shaped window was prepared using round burs connected to straight handpiece and constant saline solution irrigation, until the Schneiderian membrane started to be visible. Using sinus curettes, through a tapping technique, the bone window was mobilized and the sinus membrane was elevated. After the placement of the alloplastic graft, the implant osteotomy was prepared and the endosteal implants were inserted. Discussion. The preservation of the bony lateral window and elevation along with the sinus mucosa provides a better initial mechanical stability of the bone graft material as well as enhances bone regeneration, increasing the chances of successful osteo-regenerative processes. Conclusion. Performing the elevation of the Schneiderian mucosa along with the bony window as described in this case is easier, faster, minimizes the risk of mucosa perforation and reduces the postoperative stress.