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Updated: Aug 18, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
An 8-year retrospective study: 1,100 patients receiving 1,557 implants using the minimally invasive hydraulic sinus
1The Dental Implant Institute of Las Vegas, Las Vegas, NV 89146, USA. leonchen@diilv.com
Background:
For many clinicians, inadequate alveolar bone height and anatomical features of the maxillary sinus complicate sinus lift procedures and placement of endosseous implants. We present a new internal crestal approach that addresses these issues.
Methods:
Sinus burs and condensers of increasing width are used in conjunction with pliable atraumatic bone grafting mixture and hydraulic pressure from a surgical handpiece. The risk of a membrane perforation is minimized when the surgeon's tactile skill is administered in a two-stage process to first loosen and then graft bone particulate under the Schneiderian membrane. Threaded implants can then be placed in the same visit and secured via primary closure.
Results:
A retrospective investigation of 1,100 cases showed that eight implants failed and 14 required longer healing periods in patients with alveolar ridge heights varying between <1 to 5 mm.
Conclusions:
Our experience suggests that hydraulic sinus condensing is a predictable and minimally invasive alternative for prosthetic rehabilitation of maxillary anterior and posterior regions in the presence of anatomical restrictions to implant placement.