Minimally invasive transcrestal sinus floor elevation: a 10-year cohort study

We aimed to evaluate the clinical outcomes of a minimally invasive transcrestal sinus floor elevation (MI-TSFE) technique in patients with ≤4 mm residual bone height.

A retrospective cohort study included 55 MI-TSFE procedures performed between 2016 and 2025. Inclusion criteria were residual bone height ≤4 mm, bone width ≥4 mm, and absence of sinus pathosis. Outcomes assessed were intraoperative and postoperative surgical height, lateromedial length, anteroposterior width, implant survival, and complications. Categorical variables were compared using chi-square tests, quantitative variables with Student's t or Wilcoxon signed-rank test, and comparisons among three or more groups were performed using ANOVA. Correlations between quantitative variables were evaluated with Pearson or Spearman coefficients.

Mean residual bone height was 2.5 mm, increasing to 12.2 mm intraoperatively and 10.1 mm at late follow-up (mean 17 months), corresponding to a mean gain of 7.5 mm (P < .05). Multiple MI-TSFE procedures and simultaneous implant placement (83.6% of cases) were associated with improved postoperative height stability. Complications occurred in 14.5% of cases, mainly partial or total graft loss. Implant survival was 91.3%.

MI-TSFE showed favorable performance, achieving bone gains comparable to lateral approaches. This technique may broaden the indications for transcrestal sinus floor elevation in severely atrophic maxillae.