Crestal Approach Sinus Lift (Lateral Approach)

Sinus lift is indicated when the maxillary height is moderately limited. There are several methods to lift the sinus floor, depending upon bone width and density.  When bone density is low, a series of osteotomes (2) or bone expanders (2,3,4) are used to create osteotomy (condense the bone) and sinus lift (2,3).  When density is high, drills (2) and/or trephine (2) burs are used to form osteotomy and osteotomes are used to finish the lift.  With practice, sinus lift can be accomplished with immediate implant.  Sinus lift is preferable to sinus graft (lateral approach), because of less trauma.  It appears that 2-3 mm bone is enough to achieve primary stability if the bone density is reasonably high.  To raise the sinus floor between the molar roots (2, 3) can increase primary stability.  Immediate provisional can be done with sinus lift.  When bone height is limited, a short and wide implant is placed.

One of the most critical steps toward success of sinus lift is preparation.

Feature  
Bone Expander vs. Implant  
Extra Wide Implant SM, UF 2
Limited Height Trephine Bur 2 3
Uneven Sinus Floor  
Sinus Lift Master Kit Tatum

References: https://osteoready.com/techniques,

State of the Art with Sinus Augmentation - Current Approaches

上颌窦提高术 2 3 4 5 短植牙
上颌窦里潜在骨头 2 粗植牙

Cases (2014, LA)

Case 1 2 4 6 7
Procedure Sinus Lift Immediate Immediate Fistula Post Implant Immediate
Tooth # 2 5 6,7   13
CT   Design      
Surgery     Deviation    

Professionals

Xin Wei, DDS, PhD, MS 1st edition 01/08/2014, last revision 07/07/2016