As the x-ray image of the patient case shows, room for bone augmentation was created by lifting the floor of the maxillary sinus. Placement of the implants was not possible until bone grafting. The implants are placed in the newly-augmented bone and subsequently supplied with individual crowns. Figure 2 shows a patient case following 4 years of implant function. This patient was able to do without partial dentures and opt for implants.
In general, two surgical methods are available: the closed surgical approach ( Summers 1994) and the open technique (Tatum 1986).
MINIMALLY-INVASIVE CLOSED METHOD
The closed method, also referred to as the minimally-invasive method, allows for lifting of the floor of the maxillary sinus via the drill hole of the implant with special elevators. This method should only be applied if sufficient residual bone height is present. The original surgical method (Summers 1994) and our own experience have shown that a safe lift of approx. 3 mm of the floor of the maxillary sinus is possible. Refined techniques and instruments continue to advance this method. In many cases, a comprehensive, open sinus lift can be avoided!
The following figure, obtained from the textbook “Checklist – Implantology” (Authors: Cacaci, Neugebauer, Schlegel, Seidel, Thieme Publisher) details the procedure.