Lateral window for major sinus lift bone grafting: Technical note

Introduction After the loss of teeth in the posterior maxilla, the thickness or vertical height between the alveolar crest and maxillary sinus may be insufficient to place dental implants. At present, maxillary sinus lifting has become a widely used technique for augmenting bone tissue volume in the maxilla. Various surgical techniques can be applied to achieve a sufficient bone volume in order to place implants. Among the techniques used for lateral surgical access to the antral cavity, the technique of complete removal of the bony window through rotary instruments, and the technique of partial conservation of the window with the overturning inside the sinus (trap door) are widely known. In this article the authors present an alternative to surgical access, using a technique with a minor invasive approach with a high biological value. This method provides a lateral access to the maxillary sinus with a minimally invasive osteotomy. The osteotomic incision, of very reduced dimensions, must be performed with perfectly regular lines to delimit a rectangular shape, and convergent incisions in the cavity direction, realizing a true chamfer and preserving the integrity of the Schneiderian membrane. Case report A 54-year-old female presented in our dental clinic to replace the right superior premolars. Implants were placed after performing a anthrostomy and maxillary sinus lift with a new technique. In order to guarantee greater stability to bone plug a membrane of PRF (Platelet Rich Fibrin) was placed according to the Choukroun Technique and the flap was sutured. Finally prosthetic rehabilitation was completed after six month. Conclusion The technique of sinus lift with side access, with purposes of implant prosthetic rehabilitation, is characterized by high predictability of success. Among the techniques of lateral surgical access to the antral cavity, the technique of complete removal of the bony window through rotary instruments and the technique of partial conservation of the window with the overturning inside the sinus (trap door) are widely known. In this paper we have described a new surgical technique less invasive, infact, in any case it is essential, irrespective of the technique used, preserving the integrity of the Schneiderian membrane.