Sinus Floor Elevation Technique Research Articles

Flapless, CBCT‐guided osteotome sinus floor elevation with simultaneous implant installation. I: radiographic examination and surgical technique. A prospective 1‐year follow‐up

Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable with those placed in non-augmented sites. Flapless implant surgery can minimize postoperative morbidity, alveolar bone resorption and crestal bone loss. The use of cone beam computerized tomography (CBCT) provides 3D presentations with reduced dose exposure. To evaluate a flapless, CBCT-guided transalveolar sinus floor elevation technique with simultaneous implant installation. Fourteen consecutive patients in need of maxillary sinus floor augmentation were enrolled in this study. Preoperative CBCT with a titanium screwpost as an indicator at the intended implant position was used to visually guide the flapless surgical procedure. Twenty one implants all with a length of 10 mm and a diameter of 4.1 and 4.8 mm were inserted and followed clinically and with CBCT for 3, 6 and 12 months postoperatively. Intraoral radiographs were taken for comparison. All patients were provided with permanent prosthetic constructions 8-12 weeks after implant surgery. Ten (47.6%) implants were inserted in residual bone of 2.6-4.9 mm and 11 (52.3%) implants were inserted in residual bone of 5-8.9 mm. No implants were lost after surgery and follow-up. There was no marginal bone loss during the follow-up verified by CBCT. The implants penetrated on average 4.4 mm (SD 2.1 mm) into the sinus cavity and the mean bone gain was 3 mm (SD 2.1 mm). Flapless transalveolar sinus lift procedures visually guided by preoperative CBCT can successfully be used to enable placement, successful healing and loading of one to three implants in residual bone height of 2.6-8.9 mm. There was no marginal bone loss during the 3-12 months follow-up.

Osteotome sinus floor elevation without bone grafting and simultaneous implant placement in the atrophic maxilla: A pilot study

This study evaluated the clinical and radiographic outcome of implants placed in the posterior maxilla with the osteotome sinus floor elevation (OSFE) technique without graft material. Twenty-seven 4.1-mm-diameter dental implants (Straumann AG, Basel, Switzerland) were placed to 17 sinuses with residual bone height of ≤ 10 mm and ≥ 5 mm to rehabilitate 23 molar and 4 premolar sites. Implants were simultaneously placed with the OSFE procedure without graft material. All implants were successfully integrated after 8-12 weeks healing time. At the 2-year follow-up, all the implants presented the survival criteria proposed by Buser et al. and Cochran et al. The OSFE technique without grafting material may be predictable because the success rate was 100% in this study. Implants gained endo-sinus bone despite the lack of graft material. More patients and longer follow-up are needed to validate the results of this pilot study.

Maxillary Sinus Augmentation by the Crestal Core Elevation Technique

The crestal core elevation (CCE) technique is reportedly a less invasive procedure than the lateral window elevation technique. We retrospectively evaluated long-term outcomes of CCE procedures over an 11-year time period. Core preparations were made after extractions of 57 upper molars in 45 patients. Extraction sites were drilled with a calibrated trephine bur to an estimated distance of 1 mm from the sinus membrane. The trephined interradicular bone and underlying sinus membrane were imploded into the sinus. The surgical crater and residual extraction socket were filled with deproteinized bovine bone mineral or freeze-dried bone allograft, stabilized, and protected with an absorbable collagen membrane and fully covered with coronally positioned flaps. Implants were placed 4 months later. Success was defined if ≥9 mm available bone height was available. Where the available bone height varied between 7 and 9 mm, implant placement was complemented using the bone-added osteotome sinus floor elevation technique; those sites were defined as a "partial success." The CCE technique was successful in 31 (68.9%) out of 45 sites, and partially successful in six (13.3%) out of 45 sites. Eight sites failed (17.8%). Surgical failures were caused by core detachment resulting in large tears of the sinus membrane. Implants placed in successful sites presented a 100% survival rate during the study duration. CCE implemented simultaneously with molar extractions provided therapeutic benefits and clinical limitations. The subsequent implant placement using CCE revealed an excellent survival rate in the study population evaluated.

An unusual complication of osteotome sinus floor elevation: benign paroxysmal positional vertigo

Maxillary sinus floor elevation in cases of reduced vertical bone height in the posterior maxilla allows predictable implant placement. The osteotome sinus floor elevation (OSFE) technique has shorter healing and waiting times because the fixture can be placed in the implant recipient site simultaneously with the ridge augmentation. Implant site preparation is more comfortable for the patient when performed with spiral drills than with continuous malleting of the osteotomes. Membrane perforation is the most frequent complication with the OSFE technique; postoperative infection is rare. Benign paroxysmal positional vertigo (BPPV) may be a complication of OSFE and may cause stress if not identified correctly and managed properly. The available treatment options, diagnostic strategies and the pathophysiology of this unusual complication are discussed. The authors present a case in which intense BPPV developed during OSFE, focusing on dental and maxillofacial surgery as risk factors for this pathology.

Osteotome sinus floor elevation technique without grafting: a 5‐year prospective study

To evaluate the long-term stability of peri-implant bone formation following implant placement without grafting into resorbed posterior maxillae. Twenty-five implants of 10 mm were placed in 17 patients to rehabilitate atrophic maxillae by means of an osteotome sinus floor elevation (OSFE) procedure without grafting. Mean residual bone height was 5.4±2.3mm. Bone levels were evaluated at 1, 3 and 5 years using periapical radiographs. All implants fulfilled survival criteria and gained peri-implant bone (mean increase 3.2±1.3mm). Implant protrusion into the sinus decreased from 4.9±1.9mm after surgery to 1.5±0.9mm after 5 years. Mean crestal bone loss amounting to 0.8±0.8mm stabilized over the 5-year observation interval. Twenty implants showed additional peri-implant bone gain following the 1-year control. Implant rehabilitation of atrophic maxillae may be greatly simplified using implants 10mm and the OSFE technique without grafting. Grafting material is not needed to gain at least 3mm of bone in the atrophic maxilla. The procedure appears predictable with favourable long-term results.

Piezoelectric-Assisted Osteotome-Mediated Sinus Floor Elevation: An Innovative Approach

Sinus floor elevation can be done by lateral maxillary approach or crestal approach by osteotome techniques as a function of residual bone height. The osteotome technique has been developed for minor sinus floor elevation. This is a method with relatively high predictability but is technically demanding. During the past decade, different osteotome-mediated sinus floor elevation techniques have been developed to augment the sinus for predictable implant placement. All these methods aim to access a better, predictable sinus augmentation with low morbidity. Some of these techniques require special equipment or materials, complicated procedure, and a long learning curve. This article describes an innovative approach to sinus augmentation, namely, piezoelectric-assisted osteotome-mediated sinus floor elevation. This method uses a newly designed piezoelectric tip, which can perform sinus floor osteotomy in a simple and atraumatic way. This approach has the greatest advantages of good tactile sense in osteotomy, least perforation, patient comfort with the least and lightest malleting, and shortened surgery. This method may be the most favorable osteotome technique in the future.

Osteotome sinus floor elevation with or without grafting: a preliminary clinical trial

This clinical trial aimed (1) to evaluate the predictability of the osteotome sinus floor elevation (OSFE) technique, (2) to study the influence of simultaneous grafting on the clinical success of placing dental implants in the posterior maxilla using OSFE and (3) to observe the bone changes in the elevated space with OSFE without grafting. Two hundred and eighty Straumann implants were placed in the posterior maxillae of 202 patients using OSFE. One hundred and ninety-one implants were placed in 125 patients without grafting. The implants were allowed to heal for 3-4 months for non-grafted implants and for 6-8 months for grafted cases. For radiographic analyses, periapical and panoramic radiographs were taken of 30 implants at 3 and 9 months to assess the bone changes for the elevated sites without grafting. Two hundred and sixty-eight of 280 implants fulfilling the survival criteria represented a cumulative survival rate of 95.71%. The residual bone height (RBH) was 5.6+/-2.5 mm for the non-grafted group and 4.7+/-2.1 mm for the grafted group. The perforation rate was 4.29%. No significant differences were found between the two groups in RBH, survival rate or membrane perforation rate. The radiographic analyses demonstrated that new bone formation in the elevated sinus was visible and the endo-sinus bone gain was 2.26+/-0.92 mm and 2.66+/-0.87 mm at 3- and 9- month follow-up, respectively. Crestal bone loss (CBL) was 0.89+/-0.5 and 1.2+/-0.48 mm at 3 and 9 months. For the two test groups, RBH did not have a significant influence on the survival of the implants. At the 9-month follow-up, the endo-sinus bone gain and CBL were not significantly correlated to RBH. The implant protrusion length was significantly correlated to the endo-sinus bone gain. The findings of this study indicated that uneventful osseointegration may be predictable on applying OSFE whether with or without grafting in atrophic posterior maxilla. Spontaneous new bone formation seemed to be expected with implants placed using OSFE without simultaneous grafting.

A hybrid technique for sinus floor elevation in the severely resorbed posterior maxilla

PurposeThis study aimed to evaluate the effectiveness of the modified sinus floor elevation technique described hereafter as a "hybrid technique," in 11 patients with severely resorbed posterior maxillae.MethodsEleven patients who received 22 implants in the maxillary premolar and molar areas by the hybrid technique were enrolled in this study. A slot-shaped osteotomy for access was prepared on the lateral wall along the lower border of the sinus floor. The Schneiderian membrane was fully reflected through the lateral slot. Following drilling with the membrane protected by a periosteal elevator, the bone was grafted. All implants were placed simultaneously with sinus augmentation. The cumulative success rate was calculated and clinical parameters were recorded. Radiographic measurements were performed.ResultsAll implants were well maintained at last follow up (cumulative success rate=100%). The mean residual bone height, augmented bone height, crown-to-implant ratio, and marginal bone loss were 4.1±1.64 mm, 8.76±1.77 mm, 1.21±0.33 mm, and 0.34±0.72 mm, respectively.ConclusionsSimultaneous implant placement with sinus augmentation by hybrid technique showed successful clinical results over a 2-year observation period and may be a reliable modality for reconstruction of a severely resorbed posterior maxilla.

Osteotome sinus floor elevation technique without grafting material: 3‐year results of a prospective pilot study

In a prospective pilot study, short< or =10 mm ITI-SLA implants were placed in the resorbed posterior maxilla by means of an osteotome sinus floor elevation (OSFE) procedure without grafting material. This paper presents 3-year data assessing bone-level changes around implants. Twenty-five implants were placed in 17 patients to rehabilitate 16 molar and nine premolar sites. The mean residual bone height (RBH) was 5.4 +/- 2.3 mm. A healing period of 3-4 months was allowed before abutment tightening. Most implants (21/25) were 10 mm long, and the others were 8 and 6 mm long. At the 3-year control, endo-sinus bone gain, implant length protruding into the sinus and crestal bone loss (CBL) were measured on periapical radiographs. All implants fulfilled the survival criteria. Despite the absence of grafting material, implants were embedded into newly formed bone tissue. All implants gained endo-sinus bone; the mean gained bone was 3.1 +/- 1.5 mm. The residual protrusion length decreased from 4.9 +/- 2.1 to 1.8 +/- 2.1 mm. CBL was 0.9 +/- 0.8 mm. This study confirms that the OSFE procedure without grafting material is sufficient to create bone beyond the natural limit of the sinus. On the mid-term of 3 years, the technique was found to be predictable in the posterior maxilla when the RBH is limited. Implants gained endo-sinus bone despite the lack of grafting material. Bone gain was still improving over the first-year control. No shrinkage of the augmented area was observed.

Transalveolar maxillary sinus floor elevation using osteotomes with or without grafting material. Part II: radiographic tissue remodeling

To evaluate the pattern of tissue remodeling after maxillary sinus floor elevation using the transalveolar osteotome technique with or without utilizing grafting materials. During the period of 2000-2005, 252 Straumann dental implants were inserted using the transalveolar sinus floor elevation technique in a group of 181 patients. For 88 or 35% of those implants, deproteinized bovine bone mineral with a particle size of 0.25-1 mm was used as the grafting material, but for the remaining 164 implants, no grafting material was utilized. Periapical radiographs were obtained with a paralleling technique and digitized. Two investigators, who were blinded to whether grafting material was used or not, subsequently evaluated the pattern of tissue remodeling. The mean residual bone height was 7.5 mm (SD 2.2 mm), ranging from 2 to 12.7 mm. The mean residual bone height for implants placed with grafting material (6.4 mm) was significantly less compared with the implants installed without grafting material (8.1 mm). The implants penetrated on average 3.1 mm (SD 1.7 mm) into the sinus cavity. The measured mean radiographic bone gain using the transalveolar technique without grafting material was significantly less, 1.7 mm (SD 2 mm) compared with a mean bone gain of 4.1 mm (SD 2.4 mm), when grafting material was used. Furthermore, the probability of gaining 2 mm or more of new bone was 39.1% when no grafting material was used. The probability increased to 77.9% when the implants were installed with grafting material. When the transalveolar sinus floor elevation was performed without utilizing grafting material, only a moderate gain of new bone could be detected mesial and distal to the implants. On the other hand, when grafting material was used, a substantial gain of new bone was usually seen on the radiographs.

Sinus Floor Elevation From a Maxillary Molar Tooth Extraction Socket in a Patient With Chronic Inflammation

The compromised nature of the residual interradicular bone after extraction of periodontally hopeless maxillary molars often requires a sinus elevation procedure to ideally place the implants to accept future prosthesis. Maxillary sinus elevation surgery is a procedure used to increase the volume of bone mass so that dental implants can be placed. This article documents a sinus floor elevation technique through an extraction socket in a 65-year-old white male with chronic inflammation to increase the bone mass after the extraction of a periodontally involved maxillary molar tooth. Computerized tomography revealed an increased thickness of the sinus membrane, which was attributed to possible chronic sinus inflammation and periodontal inflammation. After consultation with the Department of Otolaryngology, it was diagnosed as chronic inflammation without any contraindication for sinus elevation surgery or implant placement. One month after the extraction, the sinus floor elevation surgery was performed through the extraction socket, and implants were placed 4 months later. An uneventful healing was noted after 6 months of osseointegration; two porcelain-fused-to-metal crowns were fabricated. Clinical follow-up took place every 3 months for 3 years, and successful healing was achieved. The patient was satisfied with the esthetic and functional results of the oral rehabilitation. Sinus floor elevation through an extraction socket without any residual bone, followed by dental implant placement, provided successful functional results and acceptable stability.

Gradual and safe technique for sinus floor elevation using trephines and osteotomes with stops: a cadaveric anatomic study

The aim of this study was to develop a new technique for maxillary sinus floor elevation through the crestal approach, using trephines and osteotomes with stops, and to assess the risk of sinus membrane lesion. The study was performed on 30 heads removed from fresh nonpreserved cadavers with subsinus bone height >or=5 mm. The anatomic specimens were sectioned axially on a plane passing 1 cm below the infraorbital foramen, to be able to see and film the sinus floor covered by the membrane. A total of 112 implants were placed using this technique (48 without grafting material and 64 with grafting material). Using this technique, we obtained a 4-6 mm elevation of the sinus membrane without impairing the mucosa. In the 13 cases where membrane lesions were observed, 9 had been performed without grafting material. The greater the initial subsinus bone height, the higher the elevation observed. The success of this technique was due to stops on the trephines and osteotomes, which reduced the risk of invading the sinus cavity and made it possible to lift the membrane gently, fully controlling movements. This technique is indicated for large crests of type III or IV bone and with a minimal bone height of 5 mm.

Resonance frequency analysis of stability on ITI implants with osteotome sinus floor elevation technique without grafting: a 5‐month prospective study

The aim of the present study was to (1) monitor the stability changes of ITI implants placed in atrophic posterior maxillary ridges with osteotome sinus floor elevation (OSFE) without grafting during the first 5 months of healing utilizing resonance frequency analysis (RFA) and (2) determine the factors that affect the implant stability quotient (ISQ) at placement and healings. Forty-two ITI implants were placed in the posterior maxilla in 32 patients with OSFE without bone grafting. The residual vertical bone height ranged from 4 to 8 mm (average 6.36 mm). Bone type was classified into one to four groups according to the Lekholm and Zarb index. ISQ was tested on the day of surgery and consecutively at 2, 4, 6, 8, 12, 16, and 20 weeks by RFA. The 40 osseointegrated implants represented a survival rate of 95.2%. All the 40 implants achieved good primary stability and reached a comparably high stability at 16 weeks postoperation with a dip between 2 and 6 weeks in the stability curve. There was no significant difference of ISQ between type3 and type4 bone at implant placement and follow-up. The mean ISQ and its changing pattern did not demonstrate a statistically significant difference according to the pretreatment vertical bone height and implant length. The findings of this study indicated that uneventful osseointegration may be predictable applying OSFE alone with no grafting in atrophic posterior maxilla. Residual bone height (RBH), implant length, and bone type did not seem to affect the implant stability in this clinical situation.

Osteotome sinus floor elevation using Choukroun's platelet-rich fibrin as grafting material: a 1-year prospective pilot study with microthreaded implants

The aim of this prospective study was to document, radiographically, changes in the apical bone levels on microthreaded implants placed in subsinus residual bone height, according to a bone-added osteotome sinus floor elevation technique with platelet-rich fibrin (PRF) as grafting material. Implants were placed using PRF as grafting material in the bone-added osteotome sinus floor elevation (BAOSFE) technique. The survival rate at abutment tightening (6 to 12 weeks of healing) and at 1 year was calculated. The radiographic analysis determined on consecutive radiographs: 1) the mean residual bone height (RBH) under the maxillary sinus at implant placement; and 2) the change in endosinus bone level. Mean and standard deviation were used to assess the endosinus bone changes in the mesial and distal implant sides at 1 year. Between December 2004 and June 2005, 20 consecutive patients were included in the study after bone height measurement by periapical radiographs. Patients included 14 women (70%) and 6 men (30%) with a mean age of 54.8 +/- 11.1 years, range 35 to 73 years; they were treated with 35 Astra Tech implants (Astra Tech Dental Implant System; Astra Tech, Mölndal, Sweden) fulfilling the inclusion criteria. The mean healing time before abutment tightening was 8.3 +/- 1.4 weeks (range 6-12 weeks); by this time, 1 implant was mobile and was removed. At 1 year, all implants were clinically stable and the definitive prostheses were in function, resulting in a survival rate of 97.1%. Nineteen implants (55%) were 11 mm long, 6 implants (17%) were 9 mm, 5 implants (14%) were 8 mm, and 5 implants (14%) were 13 mm. The RBH was measured after implant placement on the radiographs on both implant sides. The mean RBH was 6.5 +/- 1.7 mm: 6.3 +/- 1.3 on the mesial side and 6.7 +/- 2.0 mm on the distal side. Measurements of the changes in the endosinus level on the mesial and distal sides showed that all implants gained endosinus bone. The mean endosinus gain was 3.2 +/- 1.5 mm: 3.5 +/- 1.4 mm on the mesial side and 2.9 +/- 1.6 mm on the distal side. The lowest bone gain was 0.9 mm and 0.1 mm on the mesial and distal sides, respectively. The highest gain was 5.8 mm and 5.2 mm on the mesial and distal sides, respectively. The BAOSFE procedure with PRF as grafting material can lead to an endosinus bone gain. Despite a limited RBH, a healing period of 2-3 months was found to be sufficient to resist a torque of 25 N.cm applied during abutment tightening. At 1 year, formation of a new recognizable bone structure delimiting the sinus floor was identified radiologically and led to a predictable implant function.

Osteotome Sinus Floor Elevation and Simultaneous Placement of Implants – A 1‐Year Retrospective Study with Astra Tech Implants

The bone support for implants in the posterior part of the maxilla is often poor. This condition may be treated with augmentation of the maxillary sinus floor. The most common technique used is to elevate the sinus floor by inserting a bone graft through a window opened in the lateral antral wall, although less invasive techniques with osteotomes have been used since 1994. The aim of this study was to evaluate the clinical and radiographic outcome of implants placed in the posterior maxilla with the osteotome sinus floor elevation (OSFE) technique without grafting. The study population comprised 36 consecutive patients in whom 53 implants were inserted with the OSFE technique. The indication for sinus floor elevation was that the bone height below the maxillary sinus was considered to be 10 mm or less. The mean height of the alveolar process in the intended implant sites was 6.3 +/- 0.3 mm, and the mean elevation of the sinus floor was 4.4 +/- 0.2 mm. At the 1-year follow-up, two implants had been lost, both in edentulous patients. The remaining 51 implants inserted were in function, giving a 1-year cumulative survival rate of 96%. Implants used in single-tooth replacements and in partially edentulous cases had a 100% survival rate. The mean marginal bone level at the time of loading of the implants was 0.1 +/- 0.04 mm below the reference point. One year later, the corresponding value was 0.5 +/- 0.06 mm. The mean bone loss between the two examinations was 0.4 +/- 0.05 mm. The OSFE technique, without bone grafts, was found to produce predictable results in the treatment of 36 patients with restricted bone volume in the posterior part of the maxilla.

A new technique for the transcrestal sinus floor elevation and alveolar ridge augmentation with press-fit bone cylinders: A technical note

The minimally invasive sinus floor elevation as first described by Summers is limited in the volume of augmentation that is possible. In contrast, the more invasive approach is the sinuslift of Tatum which is indicated for greater bone deficiencies. Therefore, a new technique was developed for transcrestal elevation of the sinus floor and alveolar ridge augmentation with bone dowels in press-fit technique. The crestal cortical bone is cut with a hollow grinder followed by an indirect sinus floor elevation with a plunger. The cylindrical defect is then filled with a cylindrical bone transplant with the press-fit technique. The method was tested in ten fresh porcine skulls and was successful when applied subsequently in two fresh human cadavers (both female, age 60 and 92 years). This was followed by the insertion of another cylinder in overlapping mosaic manner with the dowel-lift technique in the left maxilla in one cadaver. A sinoscopy of the second cadaver experiment showed no perforation of the maxillary sinus membrane. The result was convincing. A new method for transcrestal elevation of the maxillary sinus floor and alveolar ridge augmentation with bone cylinders in press-fit technique was developed. The operation combines the minimally invasive approach of Summers with a large augmentation volume otherwise requiring the direct technique of Tatum. These results should encourage further preclinical experiments.

Evaluation of clinical results on osteotome sinus floor elevation and dental implant placement (122 cases report)

To evaluate the clinical results of osteotome sinus floor elevation technique in the posterior maxillary region. A total of 122 patients underwent osteotome sinus floor elevation from July 1998 to July 2004. Forty-eight cases were male and 74 were female. The mean age was 46.5 years (between 20 and 69). A total of 157 implants were placed and restored. The mean follow-up time was 29.7 months (between 14 and 84 months). Clinical examination and radiographs were conducted. All the patients with 8 - 11 mm height of residual bone in the posterior maxilla underwent sinus floor elevation and implant placement using osteotome without any bone grafts simultaneously. The elevation height was 2 - 5 mm. Healing abutments were connected at the same time of implant placement with insertion torque over 0.25 N.m and the final prostheses were restored after 3 - 4 months. Implants were submerged if the insertion torque was less than 0.25 N.m. Second-stage operation was conducted 3 - 4 months later and the implants were restored afterwards. Sinus membrane perforation was observed in 12 cases, no sinus complication was observed during the follow-up. All of the 157 implants gained osteointegration and were restored. No implant lost was observed during the follow-up. All the patients were satisfied with the final prostheses. Osteotome sinus floor elevation without any bone graft was a predictable and safe technique. It could be used in the maxillary posterior area implant placement with residual bone volume of 8 - 11 mm.

Sinus Floor Elevation Using Osteotomes: A Systematic Review and Meta‐Analysis

Various techniques of sinus floor elevation (SFE) are described. The elevation with osteotomes (OSFE) from a crestal approach is a relatively new technique. The aim of this systematic review and meta-analysis was to evaluate the clinical outcome of implants placed into the maxillary sinus augmented with an OSFE technique. A systematic online and manual review of the literature identified articles dealing with OSFE. Applying rigid inclusion criteria, screening and data abstraction were performed independently by two reviewers. The follow-up of loaded implants was a minimum of 6 months. The identified articles were analyzed regarding implant outcome and defined surgical aspects. Survival and success rates were estimated by Kaplan-Meier curves. Eight out of 44 articles dealing with osteotome sinus floor elevation met the inclusion criteria. Five of the studies met established success criteria. The survival and success rates were 95.7% and 96.0% after 24 months and 36 months, respectively. The median and mean follow-up periods were 24 and 18.73 months for the survival rate and 24 and 19.7 months for the success rate. Regarding different surgical elements, i.e., osteotome techniques, implant types, and augmentation materials, the database was multivariate. Thus, no statistical analysis could be performed on these parameters. Short-term clinical success/survival (<or years) of implants placed with an osteotome sinus floor elevation technique seems to be similar to that of implants conventionally placed in the partially edentulous maxilla. Controlled prospective clinical studies are needed to evaluate the long-term outcome and various surgical modifications of OSFE.

Sinus Floor Augmentation and Simultaneous Implant Placement, Part I: The 1-Stage Approach

Osteotome sinus floor augmentation is a simple and conservative technique to increase the bone height on the sinus floor. In this report, a patient with a bone height of 5 to 6 mm in the extracted site of #3 was simultaneously treated with the osteotome sinus floor elevation technique and nonsubmerged implant placement. At 1-year follow-up, the entire length of the 10-mm-long implant was covered with new bone and the implant was solid and functional.

Hydrodynamic Ultrasonic Maxillary Sinus Floor Elevation Technique Versus Closed Maxillary Sinus Floor Elevation.

Hydrodynamic Ultrasonic Maxillary Sinus Floor Elevation Technique Versus Closed Maxillary Sinus Floor Elevation.