Short Implants and Indirect Sinus Lift Versus Direct Sinus Lift With Standard-Length Implants: A Case Report

The choice of implant length in relation to the available bone quality and quantity and biting force is a critical factor in the success of implants and longevity of the prosthesis. Long implants have always been considered more desirable in this respect but in patients with advanced alveolar bone resorption, their placement is problematic due to the anatomic boundaries. This holds more true in relation to the posterior maxilla wherein the residual crestal bone height is usually compromised due to pneumatizing sinus floor. In this study, we have incorporated the use of short implants in conjunction with indirect sinus lift for cases with severely resorbed posterior maxillary edentulous regions to avoid direct sinus lift surgery and increase patient comfort. A 63-year-old patient had tooth 16 missing and wanted implant rehabilitation. The residual alveolar bone height was 3 mm. Short implant placement after indirect sinus lift was achieved with good primary stability. Prosthetic loading was performed after six months. One year follow-up showed no complaints or discomfort. In cases where the residual alveolar bone height of the edentulous space in the posterior maxilla was less than 4 mm, the use of indirect sinus lift with placement of short implants (height < 6 mm) proved to be advantageous over a direct sinus lift procedure with delayed placement of standard-length implants. This technique was less time-consuming, less surgically morbid, and more economical. The patient compliance was superior and no complaints were faced in a one-year follow-up period.