Different techniques in transalveolar maxillary sinus elevation: A literature review

Abstract

Dental implant treatment in the posterior maxilla encounters bone quality and quantity problems. Sinus elevation is a predictable technique to overcome height deficiency in this area. Transalveolar sinus elevation is a technique that is less invasive and less time-consuming, first introduced for ridges with at least 5 mm of bone height. Many modifications and innovative equipment have been introduced for this technique. This review aimed to explain the modifications of this technique with their indications and benefits. An exhaustive search in PubMed Central and Scopus electronic databases was performed until December 2020. Articles were selected that introduced new techniques for the transalveolar maxillary sinus approach that had clinical cases with full texts available in the English language. Finally, twenty-six articles were included. The data were categorized and discussed in five groups, including expansion-based techniques, drill-based techniques, hydraulic pressure techniques, piezoelectric surgery, and balloon techniques. The operator’s choice for transalveolar approach techniques for sinus floor elevation can be based on the clinician’s skill, bone volume, and access to equipment. If possible, a technique with simultaneous implant placement should be preferred.

Osseodensification by Densah Burs Versus Osteotome for Transcrestal Maxillary Sinus Lifting With Simultaneous Implant Placement

“…Sinus lifting techniques has been improved all over the years, starting with lateral approach, followed by transcrestal approach and its modifications. Summers was the first to describe transcrestal approach in 1994, several techniques were used in addition to osteotome (18), until 2016 when Hauwis and Meyer introduced the densah burs and introduced using it in sinus lifting (13). In the current study, we compared the effect of densah burs versus osteotome in transcrestal maxillary sinus lifting in 12 patients.…”

Evaluation of Transcrestal Hydrodynamic Piezoelectric Internal Sinus Elevation With Simultaneous Implant Placement. (A Clinical and Radiographic Study)

“…It is becoming more common to repair vertically resorbed ridges before implant placement to optimize implant fixation and future osseointegration (7,8). To ensure a successful implant therapy, various sinus floor lift techniques have been tried to increase the availability of bone in this location (9). Tantun (10) proposed the procedure in 1976, which involved surgical access gained to the sinus by entering the lateral wall of the maxillary zygomatic buttress followed by insertion of bone grafting substance (10).…”

“…The membrane is gently detached with a latex balloon inflated with saline solution and inserted via a hole through the lateral wall of the sinus. In 2006, Kfir et al, (18) demonstrated a crestal sinus elevation utilizing the inflating balloon procedure, with placement of dental implants and bone grafts simultaneously in the same surgical step (9). It is, nonetheless, technically challenging, and costeffective.…”

“…A physiological solution exposed to piezoelectric cavitation and piezoelectric elevators are adopted to elevate the Schneiderian membrane from floor of the sinus. Because of its surgical power of a functional frequency of 25-29 kHz, Piezoelectric internal sinus elevation has been shown to have good tactile sense (9,19) and limited bone cutting of just mineralized structures (20,21). Unlike previous transcrestal sinus lift procedures, this one is non-invasive.…”

“…It has been reported that the hydrodynamic pressure applied to the membrane is uniformly dispersed because of its centrifugal direction, which causes the Schneiderian membrane to gradually detach (9,23). Pressure applied to the membrane only placed to its top when employing osteotomes lift procedure followed by hand instruments, and while pressing upwards the whole membrane is subjected to ripping stresses however it is not sufficiently raised in comparison to intralift sinus procedure (9,21,22,23).…”