A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability

Figure 1. Difficulties in preserving crestal bone and maintaing proper angulation without the use of intermediary (Salvin/Drew) osteotomes. Figure 2. Illustration of the sequencing of the intermediary (Salvin/Drew) and divergent (Salvin) osteotomes.

A combination of divergent and intermediary osteotomes is used to prepare the osteotomy during crestal sinus floor elevation. A surgical stent is used to mark the proposed osteotomies. Radiographic measurements are taken from the osseous crest to the floor of the sinus, and the osteotomies are prepared 1 mm short of the sinus floor to allow the bone graft to lift the floor of the sinus. The final shaping drill is used primarily in virgin bone before placing the tapered implant fixture.

Figure 4 . Osteotome sinus lift and simultaneous placement of parallel-wall fixture in the #4 edentulous area. (a) Preoperative intraoral view of the #4 area. (b) Preoperative radiograph shows inadequate vertical bone height in the #4 area. (c) Postoperative radiographic evidence of well-contained graft material and parallel wall implant fixture 4 × 13 mm. (d) Temporization of the #4 implant after 3 months of healing. Figure 5. Osteotome sinus lift and simultaneous placement of natural taper fixture in the #13 edentulous area. (a) Preoperative intraoral view of the #13 area. (b) Preoperative radiograph shows inadequate vertical bone height in the #13 area. (c) Postoperative radiographic evidence of well-contained graft material and tapered implant fixture 4/3 × 13 mm. (d) Temporization of the #13 implant after 3 months of healing.