Sinus Membrane Elevation Research Articles

Minimally Invasive Sinus Augmentation: A Systematic Review.

Technology improvement and a better understanding of sinus anatomy and wound healing in the past decade have allowed the development of minimally invasive surgical techniques. This systematic review focused on identifying and describing these techniques for vertical and lateral sinus augmentation (VSA and LSA). Electronic and hand search were conducted to screen the literature published from January 2003 to May 2024. The selected studies had to include detailed techniques for minimally invasive SA. Data extraction included the study types, sample size, technique/instrument details, and outcome measurements. A total of 36 articles (27 VSA, 8 LSA with an additional 1 article included both procedures) with 2732 sinus augmentation met the inclusion criteria. Minimally invasive VSA includes the use of modified rotary instruments with stopper, balloon, hydraulic pressure, digital planning, endoscope, and operating microscope. These techniques aim for conservative flap reflection, precise sinus window preparation, and/or controlled sinus membrane elevation. Most of the selected studies (n = 15) did not report the incidence of sinus membrane perforation. Within the limitations of this review, minimally invasive VSA and LSA achieved sufficient sinus augmentation and implant success with the potential advantages of reduced surgical complications and morbidity. Comparative studies with defined outcomes are encouraged to further validate these useful minimally invasive techniques for SA.

Masticatory function in edentulous patients wearing implant overdentures after graftless maxillary sinus membrane elevation.

Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials. This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation. The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction. Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'. Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.

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.

Endo-sinus bone gain following sinus membrane elevation without graft compared with sinus floor augmentation and a composite graft: a one-year single-blind randomized controlled trial

The objective of this study was to assess endo-sinus bone gain (ESBG) and bone density (BD) following maxillary sinus membrane elevation without graft (test) compared with maxillary sinus floor augmentation and 1:1 ratio of autogenous bone from the buccal antrostomy and deproteinized porcine bone mineral (control) using two- and three-dimensional radiographic methods. Forty healthy patients were randomly allocated to the test and control groups. Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval. Significance was set at ≤ 0.05. ESBG and BD were significantly higher in the control group than test group at T1, T2, and T3 (P < 0.001). A significant decrease in ESBG and increase in BD was observed from T1 to T3 with both treatments (P < 0.001). There was a non-significant positive correlation of ESBG with implant protrusion length and non-significant negative correlation with residual bone height. In conclusion, test was associated with significantly lower ESBG and BD compared with control. However, the lower ESBG and BD did not appear to negatively affect the implant stability quotient or implant treatment outcome after 1 year of functional implant loading.

Effects of Sinus Membrane Stabilization by Dental Implant Placement and Membrane Suturing on Endo-Sinus Bone Gain in Cases of Lateral Sinus Elevation Performed Without Graft Material.

To investigate the effects of sinus membrane stabilization (via suturing) and dental implant placement on the endo-sinus bone formation in lateral sinus elevations performed without grafting. Maxillary sinus elevation surgery using the lateral approach was performed bilaterally on 30 New Zealand white rabbits. The maxillary sinus areas were divided into control and test groups. In the control group, a titanium screw was placed after sinus membrane elevation; in the test group, the sinus membrane was sutured to the lateral walls, and a titanium screw was placed in the center of the alveolar crest. The subjects were sacrificed at 4 and 8 weeks. Then samples were collected, and a microcomputed tomography (micro-CT) analysis was performed. In addition, the volume of newly formed bone, percentage of osseointegration, sinus volume, residual bone height, and implant protrusion length were measured using micro-CT analysis. The sinus volume, volume of newly formed bone, and percentage of osseointegration in the test group were significantly higher than in the control group at 4 weeks (P &#61; .01, P &#61; .04, P &#61; .02, respectively). While the volume of newly formed bone was 17.1 ± 3.08 mm3 in the control group, it was 26.9 ± 14.26 mm3 in the test group at 4 weeks. The volume of newly formed bone significantly decreased from 26.9 ± 14.26 mm3 to 17 ± 3.66 mm3 at 8 weeks (P &#61; .02). No significant difference in residual bone height was found at 4 and 8 weeks (P &#61; .07). No significant difference in implant protrusion length was found between the control and test groups (P &#61; .18). Protrusion length and new bone formation in the sinus showed a negative relationship (P &#61; .01). Suturing the sinus membrane to the lateral sinus wall is an effective approach for increasing osseointegration, bone volume, and sinus volume in the short term. A slow-absorbing suture material can be used to maintain sinus and bone volumes in the long term.

The transalveolar approach with the small segmentation method for inclined maxillary sinus floor elevation: A retrospective study.

To evaluate the clinical outcome of the transalveolar approach with the small segmentation method for inclined maxillary sinus floor elevation. Sixty-one patients with an inclined maxillary sinus floor (tilt angle ≥ 10°) and insufficient residual bone height in the posterior maxilla were included and grouped according to the tilt angle of the sinus floor, with group A having patients with the tilt angle ≥ 10° and ≤ 30° and group B having patients with the tilt angle > 30°. After completing sinus membrane elevation and bone augmentation using bone substitute materials, the implants were inserted at the same appointment, and the restoration was completed after 5-6 months of osseointegration. The preoperative sinus floor level and sinus floor elevation achieved postoperatively were assessed and recorded. At pre- and post-operative timepoints, the sagittal plane of the cone beam computed tomography was used to evaluate the bone height changes at the peak, middle and valley points in the slope segment intended for implant implantation. Osseointegration was evident in all 61 patients, and the final restoration was completed with functional loading. After assessing the normality and homogeneity of variance, two-sample t-test or nonparametric tests were employed to estimate the differences in the bone height changes. The degrees of freedom (df) for this analysis were 59. The elevation attained at the middle point in groups A and B were 6.71 ± 1.38 and 5.75 ± 1.56 mm, respectively, demonstrating a significant difference (p < 0.05). Furthermore, at the peak and valley points, group A exhibited bone height changes of 5.79 ± 1.74 and 6.06 ± 1.45 mm, respectively, compared to group B with changes measuring 4.63 ± 2.18 and 5.58 ± 2.39 mm, respectively, with no significant difference in the two groups (p ≥ 0.05). The prevalence of intraoperative sinus membrane perforation was assessed using the chi-square test. It was found that four cases in group A and five cases in group B experienced sinus membrane perforation, with no significant difference in the two groups (p ≥ 0.05, df = 1). The transalveolar approach using the small segmentation method suggests a promising approach for elevating the inclined maxillary sinus floor.

Maxillary sinus membrane elevation and coagulum compared with maxillary sinus floor augmentation and a composite graft: A 1-year single-blinded randomized controlled trial.

The aim was to evaluate the 1-year implant outcome and patient-related outcome measures (PROMs) after maxillary sinus membrane elevation and coagulum (test) compared with maxillary sinus floor augmentation and a 1:1 ratio of autogenous bone graft from the buccal antrostomy and deproteinised porcine bone mineral (DPBM) (control). Forty patients (30 female, 10 male) with a mean age of 50 years (range 25-71 years) and an alveolar ridge height between 4 and 7 mm were randomly allocated to test or control. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of the peri-implant tissue, peri-implant marginal bone loss, frequency of complications and PROMs using Oral Health Impact Profile-14 combined with questionnaires assessing patient's perception of the peri-implant soft tissue, implant crown, function of the implant, and total implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was 0.05. All suprastructures and implants were well-functioning after 1-year of functional implant loading. No significant difference in any of the applied outcome measures was observed between test and control. Both treatments revealed high patient satisfaction scores and significant improvement in oral health-related quality of life. There were no significant differences in implant outcome and PROMs between test and control, after 1-year of functional implant loading. Neither of the treatments can therefore be considered better than the other. Thus, long-term randomized controlled trials are needed before definitive conclusions can be provided about the two treatment modalities.

Lateral approach sinus (LAS) and crestal approach sinus (CAS): The unravelled paraphernalia for maxillary sinus membrane advancement

The permanent replacement of missing teeth in the maxillary posterior tooth region becomes a tedious task when it is confounded with bone atrophies. To overcome this problem and achieve successful rehabilitation, maxillary sinus membrane elevation procedures have been advocated as the most reliable means. The lateral window technique and the crestal approach are two of the most common approaches. These technologically developed procedures have reported high success rates in cases of deficient residual bone. Over time, there have been many advancements in these techniques that led to the development of user-friendly kits like the Lateral approach Sinus (LAS) kit and the Crestal approach Sinus (CAS) kit. In this case series, we have reported two cases, treated with either of these approaches and have compared the same. We aim at highlighting their ease of application in the clinical field and the promising results obtained with their use. Our clinical experience disclosed that maxillary sinus membrane advancement using both the kits have proven to be a reliable technique for implant placement in sites where insufficient bone is available.

One-Month Postoperative Reentry for Maxillary Sinus Floor Augmentation After a Large Sinus Membrane Perforation: A Retrospective Clinical and Radiographic Analysis.

The aim of this retrospective analysis was to evaluate the clinical and radiographic results of a shortened protocol (using a lateral approach) for early surgical reentry, following a large sinus membrane perforation that occurred during maxillary sinus augmentation (lateral approach), for the rehabilitation of patients with an atrophic posterior maxilla. Between May 2015 and October 2020, seven patients underwent reentry surgery using a lateral approach protocol 1 month after a large sinus membrane perforation during maxillary sinus floor augmentation with lateral approach surgery. All patients presented a residual under-sinus bone height < 3 mm in the posterior maxilla. The sinus membrane was elevated during the reentry surgery, without any difficulty for any patient, using manual blunt elevators or piezoelectric devices, and the sinus floor height was augmented with bone substitute particles. No further perforations were made, and no complications were recorded during the follow-up period from 18 months to 6 years. The 1-month waiting period after the initial sinus surgery allows easy sinus membrane elevation and a lack of complications. This timing could be a feasible option for surgical reentry after a large sinus membrane perforation occurs. Int J Periodontics Restorative Dent 2023;43:241-246. doi: 10.11607/prd.6463.

Sinus floor elevation techniques- A review

Long term edentulism in the maxillary posterior region presents with complications that compromise the quality and quantity of the residual ridge, making the implant placement impossible. Despite of these challenges, prosthetically driven dental implants tend to restore function using various sinus membrane elevation and augmentation techniques. Over the past few years, these techniques have undergone several advancements aiming to overcome the short comings of the conventional techniques and assuring a successful outcome.

Comparison of clinical and radiological outcomes using crestal approach sinus kit and piezoelectric surgery for sinus membrane elevation: A prospective clinical trial

To overcome the drawbacks of sinus floor augmentation procedures newer surgical techniques to reduce sinus perforation such as crestal approach sinus kit (CAS) and piezosurgery, which are minimally invasive procedures enabling uncomplicated sinus elevation have evolved. The aim of the present study was to investigate the performance of CAS kit compared to piezosurgery during maxillary sinus membrane elevation. A total of 40 subjects requiring maxillary sinus membrane augmentation for rehabilitation with implant prosthesis in posterior maxilla were included in the study. The current study was a prospective clinical trial where osteotomy and sinus elevation was done using CAS kit in Group 1 and piezosurgery in Group 2. Platelet-rich fibrin was placed in osteotomy site and dental implants were inserted. Implant stability was evaluated at baseline and 3 months. Crestal bone loss was measured at 3, 6, and 12 months. Apical bone gain was measured at 6 and 12 months. Intragroup comparison of the study groups was done by Paired t-test, ANOVA test, and Friedman test. Intergroup comparison was done by unpaired t-test and Mann-Whitney U-test. P < 0.05 was considered statistically significant. Implant stability improved in both the groups, i.e., 79.2 ± 5.02 and 79 ± 5.31 in Group 1 and Group 2, respectively, at 3 months. Intergroup comparison showed no difference in all parameters; however, crestal bone loss was greater in piezosurgery group with a mean difference of 0.74 mm. Both CAS and piezosurgery groups showed definitive improvement in all parameters. CAS group resulted in added benefits in terms of less crestal bone loss and intraoperative surgical time compared to piezosurgery group.

Patient's perception of recovery after sinus membrane elevation and blood coagulum compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral. Secondary outcomes from a single-blinded randomized controlled trial.

The objective was to assess patient's perception of recovery after maxillary sinus membrane elevation (MSME) and blood coagulum (test) compared with maxillary sinus floor augmentation (MSFA) and 1:1mixture of autogenous bone graft from the buccal antrostomy and deproteinized porcine bone mineral (DPBM) (control). Forty healthy patients were randomly allocated to test or control. Oral health-related quality of life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enrollment and 1week postsurgical. Recovery was estimated by questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, and discomfort after 1week and 1month. Mean differences were expressed with 95% confidence interval (CI). Association between OHRQoL and recovery was estimated. p-value below .05 was considered statistically significant. Maxillary sinus membrane elevation revealed 2.1less days of pain (p=.03, 95% CI: 0.2-4.1) and 1.2days of sick leave (p=.01, 95% CI: 0.3-2.1) compared with MSFA. No significant difference was observed in eating and speaking ability, physical appearance, work performance, and sleep impairment. No significant association between impaired OHRQoL and recovery was observed. Females reported 4.77higher OHIP-14score compared with males (p=.01, 95% CI: 1.60-7.94), while association between age and OHIP-14 was -0.10 (p=.28, 95% CI: -0.28 to 0.08). Maxillary sinus membrane elevation revealed significantly less days of pain and sick leave compared with MSFA. Harvesting of autogenous bone graft seems, therefore, to have a significant impact on perception of recovery.

Crestal approach for the repair of the Schneiderian membrane perforated during transalveolar sinus elevation

Aim The most common complication during maxillary sinus floor elevation is perforation of the Schneiderian membrane. Most of studies presented repair procedures via a lateral approach, which can induce additional complications. Therefore, in the present study the procedure was performed via crestal approach. Case report This study included three patients who showed a low residual alveolar bone height in the maxillary posterior edentulous region and in whom the placement of implants with sinus floor elevation was planned via a transalveolar approach. Perforation of the sinus membrane occurred during the procedure, and so collagen dressing material was inserted through the drilling hole to cover the perforated membrane. Xenogeneic bone was grafted under the elevated sinus membrane, and implants were placed simultaneously. The final prostheses were delivered at 6 to 8 months after the surgery. There were no complications in any of the patients. Results All implants showed successful stability, and no specific clinical or radiographic complication was observed during follow-ups lasting 2 to 3 years. Conclusion A crestal approach can be a reliable option when repairing a sinus membrane that is perforated during transalveolar sinus floor elevation.

Microscope-Assisted Maxillary Sinus Augmentation: A Case Series.

Minimally invasive microsurgery performed using an operating microscope (OM) has shown accelerated and improved wound healing for periodontal plastic and regenerative procedures. This case series aims to demonstrate the potential usefulness of OM for maxillary sinus augmentation in a private practice setting. Twelve vertical sinus augmentations (VSAs) and 8 lateral sinus augmentations (LSAs) were performed with the assistance of OM. Flap reflection, osteotomy, sinus membrane elevation, membrane integrity evaluation, implant placement (if indicated), and wound approximation with sutures were performed under OM. After a minimum healing period of 6 months, radiographic bone height gain was assessed. One sinus membrane perforation was observed during VSA surgery. The mean vertical bone gain was 4.82 ± 1.31 mm and 8.36 ± 1.45 mm for VSA and LSA, respectively, with 100% implant success rate. OM-assisted maxillary sinus augmentation provides favorable clinical visualization, thus facilitating delicate hard and soft tissue manipulation.

Combination of a Hydraulic Device and Nanohydroxylapatite Paste for Minimally Invasive Transcrestal Sinus Floor Elevation: Procedure and 4-Year Results.

The objectives of this retrospective study were to describe a transcrestal sinus floor elevation technique combining the use of a hydraulic device and a nanohydroxylapatite paste and to report on 4-year clinical and radiographic outcomes. The sinus floor elevation procedure used a specially designed drill (SinusJet) to start sinus membrane unsticking and a nanohydroxylapatite paste (Ostim) for further sinus membrane elevation and bone augmentation. It was performed as a one-step procedure with immediate implant placement or a two-step procedure with delayed implant placement 9 months later. Implant survival rate, sinus membrane perforation, postoperative complications, and the level of intraoperative and postoperative patient comfort using a visual analog scale were analyzed retrospectively. A nonparametric Wilcoxon matched-pairs test and parametric paired t test were used to identify significant differences. One hundred thirty-six sinus floor elevations were performed in 110 patients at two dental clinics in Belgium with a mean follow-up period of 48 months. In the one-step procedure, the mean 6-month elevation was 8.5 ± 2.7 mm; 194 implants were placed. In the two-step procedure, the mean 9-month elevation was 9.5 ± 2.4 mm; 8 implants were placed. The osteotomy, sinus membrane elevation, and bone grafting typically took less than 3 minutes. Sinus membrane perforation was observed in 2.9% (n = 4/136). The 4-year implant survival rate was 97% (n = 196/202), with six early implant losses. 96.4% of patients reported either no or minimal discomfort. This minimally invasive transcrestal sinus floor elevation procedure that combines a hydraulic device and nanohydroxylapatite paste appears to be safe and predictable. However, further randomized controlled studies are needed to validate the results of this retrospective observational study.

Lateral Sinus Membrane Elevation in Case of Lateral Intra-sinus Linear Calcification: Expanding the Indications

Intra-sinus calcifications (ISCs) which are noted only in 2.4 percent of maxillary sinus pathology can be a challenging condition for the implantologists. A few studies describe only a recommendation for the centrally localized calcification spots in the maxillary sinus. Simultaneously, there is no publications focused on lateral sinus lift performance in cases of laterally, peripherally located linear ISCs. The purpose of our report is to present a surgical tactic for lateral approach of Schneiderian membrane elevation in a 58-year-old female with linear and fine punctate calcifications, inta-sinus hyperostosis, and mucosal swelling with height above the middle level of the sinus.

Lateral Sinus Membrane Elevation in Case of Lateral Intra-sinus Linear Calcification: Expanding the Indications

Intra-sinus calcifications (ISCs) which are noted only in 2.4 percent of maxillary sinus pathology can be a challenging condition for the implantologists. A few studies describe only a recommendation for the centrally localized calcification spots in the maxillary sinus. Simultaneously, there is no publications focused on lateral sinus lift performance in cases of laterally, peripherally located linear ISCs. The purpose of our report is to present a surgical tactic for lateral approach of Schneiderian membrane elevation in a 58-year-old female with linear and fine punctate calcifications, inta-sinus hyperostosis, and mucosal swelling with height above the middle level of the sinus.

Patient Perception and Radiographic Assessment of Sinus Lifting Procedure using Densah Bur versus Osteotome-mediated sinus lifting: A Randomized Clinical Trial

Aim: This study aimed to evaluate the clinical complications that might be presented with osteotome and densah burs, as well as to assess the new bone generated at 6 months post-operatively using CBCT. The study hypothesis was that densah bur would show comparable results to osteotome-mediated sinus lifting. Material and method: Ten patients were enrolled in the study with atrophied maxillary posterior edentulous area that required rehabilitation with implants and sinus membrane elevation. Sinus membrane was elevated with two techniques, Osteotome and Densah bur sinus lifting procedures. Clinical (sinus perforation, post-operative swelling, and headache/vertigo) and radiographic parameters (RBH and ESBG) were assessed. Result: In both groups, new bone levels were higher in comparison to initial levels with statistical significant difference. The mean RBH in Densah bur group (8.1 ± 1.5) was higher than the Osteotome group (6.9 ± 0.6) with p value = 0.13. Moreover, Densah bur showed higher mean ESPG than group I with 1.8 ± 0.4 and 1.4 ± 0.5 values respectively and p value = 0.21. Lastly, post-operative complications comparison showed non-significant differences between both groups except for headache and vertigo. Conclusion: The protruded implants can act as tents and allow formation of blood clot with concomitant bone regeneration. Although the two techniques applied for drilling showed comparable radiographic results, however, they displayed differences in patient perception. According to this study, it can be concluded that osseodensification surpasses osteotome- lifting procedure when it comes to patient comfort and satisfaction.

The assessment of the effect of the size of lateral-antrostomy in graftless balloon elevation of the maxillary sinus membrane with simultaneous implant placement (a randomized controlled clinical trial).

The overlying maxillary sinus frequently restrains the height of the posterior maxillary bones. Evaluating the effect of downsizing the antrostomy side-window on the stability of the installed implants and vertical bone gain, after employing a graftless antral membrane balloon elevation (AMBE). The study is a randomized controlled clinical trial conducted on 20 patients with 30 deficient maxillary alveolar ridges underwent graftless (AMBE) after being allocated into a (5 mm) entry antrostomy group (the test group) and a (10 mm) entry antrostomy group (the control group) implementing a radiographic linear bone height and implant stability quotations (ISQ) comparison among both groups immediately after the placement of 38 Implants and 6 months after. Radiographic bone gain of the test group (5.55 ± 0.93 mm) was significantly higher than the control group (2.86 ± 0.60 mm) (p <0.001). There was no significant difference in primary stability between the test (65 ± 5.32) and control groups (62.67 ± 4.46) (p = 0.202); while the test group (73.43 ± 4.39) showed significantly higher secondary stability than the control group (64.83 ± 6.05) (p <0.001). ISQ values recorded at 6 months were significantly higher than those recorded at insertion in the test group (p <0.001), while they were insignificant in the control group (p = 0.148). Undersizing the antrostomy window deemed beneficial concerning the vertical bone gain and the simultaneously placed root form dental implants' secondary stability.

Minimally Invasive Sinus Membrane Elevation Techniques: A Literature Review

Sinus augmentation surgery has become a well-accepted pre-prosthetic procedure for placement of endo-osseous implants in compromised posterior edentulous maxilla. Various procedures for bone augmentation have been used to achieve sufficient bone volume for dental implants with the lateral and crystal surgical approaches being the most common. But these bone augmentation methods, including the conventional lateral maxillary approach and sinus elevation by osteotome, have several limitations. Sinus membrane perforation is one of the most common complications of the sinus lift procedure. Thus, to overcome these limitations various minimally invasive techniques have been introduced. These techniques cause minimal postoperative pain, faster recovery and are more economical due to shorter remission period. Hence, the aim of this review article is to discuss the various minimally invasive maxillary sinus floor elevation techniques introduced.