Different techniques for transcrestal sinus floor elevation: safety, efficiency & predictability

Bone volume available for dental implant placement in the posterior maxilla is frequently reduced by maxillary sinus cxpansion and resorption of the alvcolar ridge following tooth loss. Internal bonc augmcntation of the sinus floor is routincly performed by elevation of the maxillary sinus membrane via a lateral or transcrestal approach. Comparing to lateral sinus lifting technique, transcrestal sinus floor elevation is an alternative and less invasive approach to the maxillary sinus. The key issues in minimally invasive transcrestal techniques are the avoidance of membrane perforation in the course of osteotomy and safe and sufficient amount of augmentation. Various approaches have been developed to facilitate the surgical procedure of sinus floor osteotomy and membrane elevation in order to increase the possible amount of bone augmentation while reducing the risk of perforation of the Schncidcrian mcmbranc. This rcvicw summarizes mechanism, current knowledge and experience of conventional sinus membrane elevation techniques including osteotome technique, auto-stop drills, balloon-mediated elevation, Hydraulic Pressurc-Mcdiatcd Elevation, and piczoclcctric ostcotomy with hydrodynamic sinus mcmbranc lifting. The main factors for choosing a precise transcrestal approach to sinus floor are predictability, safety, ability to simultaneous ostcotomy and clevation, and the amount of clcvation. Piezoelectric surgery is established as the new standard of bone-cutting in general oral surgery. The use of a precise, pressure-controlled hydrodynamic ultrasonic cavilation sinus lift system is an casici, safer, less invasivc and more controllable technique to gain predictable osteotomy and membrane elevation. This technique seems to provide overall higher success, lower complication rates and overcome