Sinus Lifting with Osteotome Technique in Inadequate Residual Bone Situation-Case Report

Abstract

The prerequisite for predictable osseointegration of dental implant is adequate remaining bone to provide initial stability. In mandibular posterior area, the mandibular canal and metal foramen are the limiting anatomic structures for implant placement. In maxillary posterior area, the limiting anatomic structure is the maxillary sinus. In the case of inadequate remaining bone, ridge augmentation procedure should be performed before or simultaneously with implant placement. Literatures showed that horizontal ridge augmentation to increase the bone width is more predictable than vertical ridge augmentation. Fortunately, in the maxillary posterior area, sinus lifting procedure to increase the vertical bone height seems to be more stable than in other areas of the jawbone. There are two surgical techniques for sinus lifting: lateral window technique and osteotome technique. In patients with less remaining bone, lateral window for sinus grafting and two stages approach is recommended because initial implant stability is hard to achieve. However, two stages approach will lengthen the total treatment time and the post-operative discomfort of the patient is more apparent with open window technique compared to osteotome technique. This case report will show the sinus lifting procedure using osteotome technique and implant placement concomitantly even in the compromised remaining bone condition.