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Gradual and safe technique for sinus floor elevation using trephines and osteotomes with stops: a cadaveric anatomic
Françoise Tilotta1, B Lazaroo, J-F Gaudy
1Institut d'Anatomie, Centre Universitaire des Saints-Pères, Université Paris Descartes, Paris, France. francoise.tilotta-yasukawa@univ-paris5.fr
Summary
This study introduces a new crestal approach for maxillary sinus floor elevation using specialized instruments, minimizing sinus membrane damage. The technique proved effective for bone types III and IV, with initial subsinus bone height influencing elevation success.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Anatomical Studies
Background:
- Maxillary sinus floor elevation is crucial for dental implant placement in atrophic maxillae.
- Traditional techniques carry risks of sinus membrane perforation.
- A safer, controlled method for sinus augmentation is needed.
Purpose of the Study:
- To develop and evaluate a novel crestal sinus floor elevation technique.
- To assess the risk of sinus membrane lesion using trephines and osteotomes with stops.
- To determine the efficacy of this technique in cadaveric specimens.
Main Methods:
- The technique was developed on 30 fresh cadaver heads with subsinus bone height ≥5 mm.
- Specimens were sectioned to visualize the sinus floor and membrane.
- 112 dental implants were placed using the technique, with and without grafting material.
Main Results:
- Achieved 4-6 mm sinus membrane elevation without mucosal perforation.
- Membrane lesions occurred in 13 cases, predominantly without grafting material (9 cases).
- Higher initial subsinus bone height correlated with greater membrane elevation.
Conclusions:
- The technique, utilizing stops on trephines and osteotomes, allows controlled, gentle membrane elevation.
- This method reduces the risk of sinus cavity invasion.
- It is indicated for Type III or IV bone crests with a minimum 5 mm bone height.