Transcrestal Sinus Floor Elevation with Simultaneous Implant Placement in the Posterior Maxilla: A Case Report

Abstract

Rehabilitation of the posterior maxilla with dental implants may be complicated by reduced residual alveolar bone following tooth loss and pneumatisation of the maxillary sinus. Sinus floor elevation can increase the available vertical bone height and facilitate implant placement in appropriately selected patients. This case report describes the use of an indirect crestal sinus lift with simultaneous implant placement in the maxillary right molar region of a 34-year-old female patient presenting with a missing posterior maxillary tooth for one year. Clinical examination was supplemented by orthopantomographic and cone-beam computed tomographic evaluation. Based on the available residual bone and treatment requirements, an indirect sinus floor elevation was planned. Following flap reflection, osteotomy preparation was performed using a 2-mm pilot drill under saline irrigation. Sinus elevation osteotomes of progressively increasing dimensions were used to elevate the sinus floor. A dental implant measuring 4.2 mm in diameter and 10 mm in length was subsequently placed at 20 rpm with an insertion torque of 50 Ncm. A cover screw was placed and the surgical site was sutured. Post-placement radiographic assessment was performed using an orthopantomograph. The case demonstrates the clinical application of a crestal sinus elevation technique with simultaneous implant placement for the management of limited posterior maxillary bone height. Careful radiographic assessment, appropriate patient selection and controlled surgical technique are important components of this treatment approach.