Abstract
Dental implant placement in the posterior maxilla remains a challenge due to maxillary sinus pneumatization. SFE procedures via lateral approach have overcome this obstacle, although it is considered to be a rather aggressive approach. In an attempt to reduce such morbidity, several techniques using osteotomes and different specialized instruments have been introduced to reach the sinus floor via crestal approach: Summers (Compendium 15:152, 1994a; Compendium 15:698, 1994b) described a one-stage crestal SFE approach originally indicated in the presence of a moderate residual bone height (RBH) and combined to simultaneous implant placement (OSFE, BAOSFE…), which was considered to be simpler and less invasive when compared to the lateral SFE. However, the main limitation of this “blind” crestal approach is the uncertainty of membrane integrity as a result of lack of visibility. Therefore, despite their high success rate, criticism on the safety of the crestal technique may be expressed.
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