Flapless Approach to Maxillary Sinus Augmentation Using Minimally Invasive Antral Membrane Balloon Elevation

Abstract

In the atrophic posterior maxilla, successful implant placement is often complicated by the lack of quality and volume of available bone. In these cases, sinus floor augmentation is recommended to gain sufficient bone around the implants. Sinus elevation can be performed by either an open lateral window approach or by a closed osteotome approach depending on available bone height. This case series demonstrates the feasibility and safety of minimally invasive antral membrane balloon elevation, followed by bone augmentation and implant fixation in 20 patients with a residual bone height of 2 to 6 mm below the sinus floor. The surgical procedure was performed using a flapless approach. At 18 months follow-up, the implant survival rate was 100%. Absence of patient morbidity and satisfactory bone augmentation with this minimally invasive procedure suggests that minimally invasive antral membrane balloon elevation should be considered as an alternative to some of the currently used methods of maxillary bone augmentation.

A simplified approach to the minimally invasive antral membrane elevation technique utilizing a viscoelastic medium for hydraulic sinus floor elevation

“…The use of the minimally invasive antral membrane elevation technique has a well-documented history of success and has been shown to yield success rates ranging from 95.2 to 100 % for 6 to 18 months of follow-up [19,20]. These results are comparable, yet slightly higher than those reported in a largescale survival analysis of implants placed with the osteotome technique for indirect sinus lift [21].…”

“…Results from the work of Kfir et al and Mazor et al are well within the range of 92.7-96.9 % survival reported by a systematic review for sinus lift using the transalveolar approach [5,6,20,22].…”

Resonance Frequency Analysis of Sinus Augmentation by Osteotome Sinus Floor Elevation and Lateral Window Technique

“…Etiologies including disuse atrophy, hormonal and metabolic action, use of removable prostheses, occlusal trauma, and sinus pneumatization have been implicated in the bone resorption that occurs in this region after loss of dentition. 1,2 Although alternatives such as the use of shorter implants are beginning to be investigated, 3,4 the most predictable and commonly used means of facilitating 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 implant therapy in the atrophic posterior maxilla has been sinus augmentation. This is accomplished by either of 2 principal techniques: the lateral antrostomy, or the so-called lateral window technique (LWT), published by Boyne and James 5 in 1980, and osteotome sinus floor elevation (OSFE), described by Summers 6 in 1994.…”

Ex vivo comparative study on three sinus lift tools for transcrestal detaching maxillary sinus mucosa

“…[4][5][6][7][8][9][10][11][12][13][14][15] The improved sinus lift tools for detaching the maxillary sinus mucosa could be classified into 2 types: rigid tools such as umbrella-shaped sinus lift curette YSL-04, and elastic tools such as balloons. Mazor et al 16 gently detach maxillary sinus mucosa using balloons via the uniform pressure generated by injecting water into the balloon, which significantly reduced the perforation possibility for maxillary sinus mucosa and increased the height of elevated sinus floor. Chen et al 17 utilized hydraulic pressure and pliable bone graft mixture to gently detach the soft tissue of sinus mucosa from sinus bone without the perforation risk.…”