A Modified Transalveolar Sinus Floor Elevation Approach With a Bilaterally Enlarged Osteotomy
Sinus floor elevation is the most commonly used method for vertical bone augmentation in the maxillary posterior area. This clinical report describes a modified transalveolar approach to elevate the Schneiderian membrane when placing implants on a severely resorbed maxillary posterior ridge with a buccal-palatal width of more than 8.0 mm. In this approach, the osteotomy prepared on the crestal is bilaterally enlarged to 8.0–10.0 mm. The enlarged osteotomies provide better access, allowing instruments to be in direct contact with the bone of the sinus floor and thus elevate the Schneiderian membrane with a reduced risk of perforation.
A sketch map of the modified transalveolar sinus elevation approach. (a) Bilaterally enlarged osteotomy for sinus floor elevation. (b) Elevation of sinus membrane from different angles. (c) Placement of implants.
Preoperative cone-beam computed tomography scan.
(a) Bilaterally enlarged osteotomy and removal of the sinus floor. (b) Elevation of sinus membrane from different directions using curets. (c) Fill of grafting materials and placement of an implant.
Panoramic X ray 12 months after restoration delivery.
(a) Preoperative panoramic X ray. (b) Bilaterally enlarged osteotomies and removal of the sinus floor, followed by elevation of sinus membrane from different directions.
(a) Preoperative cone-beam computed tomography scan. (b) Elevation of sinus membrane from different directions after creating 3 bilaterally enlarged osteotomies and removal of the sinus floor.
(a) Postoperative cone-beam computed tomography scan. (b) Postoperative panoramic X ray after placement of a third implant.
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