Flapless Transcrestal Maxillary Sinus Floor Elevation: computer guided implant surgery combined with expanding-condensing osteotomes protocol.

PURPOSE A novel technique for transcrestal guided sinus lift elevation (TGSL), is described underlining the step by step surgical protocol. MATERIALS AND METHODS TGSL modified osteotome technique was planned by the NobelProcera(®) Software Planning Programm (Nobel Guide, Nobel Biocare AB) and performed by stereolitographic template. The depth of the planned osteotomy was determined precisely via cross-sectional images of the elevation site to facilitate puncture of the bony sinus floor without risk of perforation of the adherent sinus membrane. A customized drilling-osteotome protocol is used to raise the Schneiderian membrane to the final implant length. RESULTS The sinus membrane is successfully elevated in all sites without any iatrogenic perforation. CONCLUSIONS The TGSL modified osteotome technique may provide a new option for minimally invasive transcrestal sinus surgery and may represent a safe method to increase bone volume in the atrophic posterior maxilla. The results of the present study would suggest that this new surgical technique may reduce patient morbidity and extend the indications for transcrestal maxillary sinus floor elevation.