A Novel Dental Implant Approach for Crestal Sinus Elevation: A Case Series Study
The aim of this study was to evaluate the radiographic and clinical outcomes of patients undergoing sinus membrane elevation via a minimally invasive crestal approach utilizing the dental implant. Twenty patients having 1 or more missing posterior teeth were included. The maxillary sinus membrane was elevated using dental implant via a crestal approach in areas with insufficient residual bone. CBCT scans were used to measure the amount of newly formed bone, implant length inside the sinus, bucco-palatal sinus width, and bone thickness. Surgical and postsurgical complications along with implant survival were also measured. The mean (±SD) values for the newly formed bone after 1 year were 2.4 (±1.87) mm, while values for implant length inside the sinus were 4 (±1.49) mm. The results showed that percentage of implant length inside the sinus and the palatal bone thickness were statistically significant positive predictors of the newly formed bone. Higher percentage of implant length inside the sinus and increased palatal bone thickness were associated with larger amounts of newly formed bone. A high patient satisfaction was reported along with a 100% implant survival. The utilization of the novel dental implant approach for crestal sinus elevation demonstrated predictable clinical and radiographic outcomes. This novel technique is simple to both patients and clinicians, rendering it a promising and cost-efficient procedure.
Diagram illustrating implant approach for crestal sinus elevation technique: (a) Mid-crestal incision and full thickness flap reflection with the pilot drill reaching 0.5–1 mm from sinus floor; (b) a blunt rounded apex implant is used to gently elevate the sinus floor after complete thinning of bone using widening drills; (c) full seating of the implant to the required length, resulting in tenting of the sinus membrane.
Clinical case presenting the implant approach for crestal sinus elevation: (a) preoperative CBCT cross sectional cut showing residual bone height of an upper left first molar; (b) occlusal view of the site with full thickness flap reflection and osteotomy before implant placement; (c) occlusal view of the site with the implant fully seated; (d) buccal view of the site showing the implant position in relation to the opposing dentition; (e) buccal view showing the final prosthesis in place; (f) a follow-up CBCT cross sectional cut showing implant and final prosthesis 3 years post loading with bone formed around the implant.
CBCT Landmarks and measurements: (a) preoperative CBCT cross-sectional cut showing residual bone height and bucco-palatal sinus width of an upper right first molar; (b) cross sectional view of the implant 2 years post loading; (c) fusion superimposition of the preoperative and the post loading scans showing the difference between the residual bone height and the newly formed bone; (d) preoperative CBCT cross sectional showing residual bone height and bucco-palatal sinus width of an upper left first molar; (e) cross-sectional cut of the implant 2 years post loading; (f) fusion superimposition of the pre-operative and the post loading scans showing the difference between the residual bone height and the newly formed bone.
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