WCOI-AAID International Podium
Dental implant therapy has gained popularity with highly predictable outcomes owing to the concept of osseointegration. Implant placement is often difficult in the posterior maxilla due to insufficient bone volume below the maxillary sinus. Boyne and James (1980) developed a technique involving grafting of autogenous bone into the sinus floor by fenestration of the lateral maxillary sinus wall to access and elevate the sinus membrane based on the Caldwell-Luc procedure. In addition, Summers (1994) developed the sinus floor elevation technique using an osteotome through alveolar crest approach. Subsequently, several modifications of sinus floor elevation techniques were described. Methods based on the former are called "lateral approach" or "lateral window technique," while those based on the latter are called "alveolar crest approach" or "osteotome technique." The lateral approach allows elevation of the maxillary sinus membrane under direct vision, and is applicable even in cases of deficient bone volume to achieve primary stability. While the alveolar crest approach is a less-invasive surgical procedure, it has several limitations. This technique is applicable only in cases with sufficient bone volume to provide primary stability to the implant, and has to be performed blindly. Furthermore, management of accidental symptoms such as damage to mucous membrane of the maxillary sinus is difficult.
Regardless of the method used, case selection, proper diagnosis, and treatment planning are extremely important.
The prognosis of implant treatment with maxillary sinus floor augmentation is extremely favorable. Consequently, maxillary sinus floor augmentation has been widely accepted as an essential technique for implant treatment in the posterior maxilla.
However, more routine application of the maxillary sinus floor augmentation technique has led to an increase in the incidence of complications. This study aimed to discuss proper treatment planning and surgical techniques to improve safety and predictability of maxillary sinus floor augmentation. I will share with you the latest trends in the procedure and present some of my clinical cases.