15Aug 2017

MAXILLARY SINUS LIFT SURGERY TECHNIQUES: A LITERATURE REVIEW.

  • Professor of Dental Prosthetics, Department of Dentistry, Faculdade Paulo Pican?o, Fortaleza ? CE.
  • School of Dentistry, Centro Universit?rio UNILE?O, Juazeiro do Norte ? CE, Brazil.
  • Graduate in Letters - English Language, Universidade Regional do Cariri - URCA, Crato ? CE, Brazil.
  • Professor of Oral Implantology, Department of Dentistry, Centro Caririense de P?s-Gradua??o CECAP, uazeiro do Norte ? CE, Brazil.
  • Professor of Dental Prosthetics, Department of Dentistry, Universidade de Fortaleza UNIFOR, Fortaleza ? CE, Brazil.
  • Professor of Dental Prosthetics, Department of Dentistry, Centro Universit?rio Cat?lica de Quixad?, Quixad? ? CE, Brazil.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Introduction: Bone atrophy and pneumatization of the maxillary sinus resulting from tooth loss, associated with low bone density in the region, often provide inadequate quantity and quality for the installation of osseointegrated implants. Aim: In the present work, a literary review was carried out to identify and compare the main techniques of maxillary sinus surgery, commenting on the available graft materials. Methodology: A bibliographic search was carried out in the main PUBMED databases, in which works were published that were published from 1955 to 2017. 86 articles met the criteria for inclusion laboratory studies, case reports and systematic reviews as well as literature that were developed In the human species; In which they had done the lifting of the maxillary sinus with allocation of the grafting material. Results: In view of a careful research and tabulations of the respective articles, the result was that in many cases it is necessary to perform a surgical procedure to increase bone height, called maxillary sinus lift. The two techniques used for this purpose are the traumatic technique and the atraumatic technique, with or without bone graft. Conclusion: Maxillary sinus lift is a safe, reliable and successful surgical procedure, provided that the fundamental principles of the technique are strictly adhered to. The risks involved are small, with possible post-operative complications amenable to treatment through medication and / or surgical interventions.


  1. Betts NJ, Miloro M. Modification of the sinus lift procedure for septa in the maxillary antrum. J Oral Maxillofac Surg. 1994, 52:332-3.
  2. Blomqvist JE, Alberius P, Isaksson S. Two-stage maxillary sinus reconstruction with endosseous implants: a prospective study. Int J Oral Maxillofac Implants. 1998, 13(6):758-66.
  3. Boyne PJ, James R. Grafting of the maxillary floor with autogenous marrow and bone. J Oral Surg. 1980, 38:613-616.
  4. Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988, 17(4):232-6.
  5. Chackartchi T. Sinus floor augmentation using large (1-2 mm) or small (0.25-1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study.Clin Oral Implants Res. 2011 22(5):473-80.
  6. Chanavaz M. Maxillary sinus: anatomy, physiology, surgery,and bone grafting related to implantology: eleven years of surgical experience (1979-1990). J Oral Implantol. 1990, 16:199-209.
  7. Chiapasco M, Ronchi P. Sinus lift and endosseous implants: preliminary, surgical and prosthetic results. Eur J Prosthodont Restor Dent. 1994, 3(1):15-21.
  8. Daelemans P, Hermans M, Godet F, Malevez C. Autologous bone graft to augment the maxxilary sinus in conjunction with immediate endosseous implants: a retrospective study up to 5 years. Int J Periodontics Restorative Dent.1997, 17(1):27-39.
  9. Davarpanah M. The modified osteotome technique. Int J Periodontics Restorative Dent. 2001, 21(6):599-607.
  10. De Melo Autogenous bone combined with anorganic bovine bone for maxillary sinus augmentation: analysis of the osteogenic potential of cells derived from the donor and the grafted sites. Clin Oral Implants Res, Jan 7, 2013.
  11. Del Fabbro M, Testori T, Francetti L, Taschieri S, Weinstein R. Systematic review of survival rates for immediately loaded dental implants. Int J Periodontics Restorative Dent. 2006, (3):249-63.
  12. Engelke W, Schwarzw?ller W, Behnsen A, Jacobs HG. Subantroscopic laterobasal sinus floor augmentation (SALSA): an up-to-5-year clinical study. Int J Maxillofac Implants. 2003, 18(1):135-43.
  13. Esposito M. Sinus lift with guided bon? regeneration or anorganic bovine bon?: 1-year post-loading resultas of a pilot randomized clinical trial. Eur J Oral Implantol. 2010, 3(4):297-305.
  14. Froum SJ. Sinus floor elevation using anorganic bovine bone matrix (OsteoGraf/N) with and without autogenous bone: a clinical, histologic, radiographic, and histomorphometric analysis - Part 2 of an ongoing prospective study. Int J Period Rest Dent. 1998, 18(6):528-43.
  15. Froum SJ. Comparison of mineralized cancellous bone allograft (Puros) and anorganic bovine bone matrix (Bio-Oss) for sinus augmentation: histomorphometry at 26 to 32 weeks after grafting. Int J Period Rest Dent. 2006, 26(6):543-51.
  16. Fugazzoto PA, Vlassis J. Long-term success of sinus augmentation using various surgical approaches and graftings materials. Int J Oral Maxillofac Implants. 1998, 13(1):52-7.
  17. Galindo-Moreno P, Avila G, Fern?ndez-Barbero JE, Aguilar M, S?nchez-Fern?ndez E, Cutando A, Wang HL. Evaluation of sinus floor elevation using a composite bone graft mixture. Clin Oral Implants Res. 2007, 18(3):376-82.
  18. Galindo-Moreno P. Histomorphometric comparison of maxillary pristine bone and composite bone graft biopsies obtained after sinus Clin Oral Implants Res. 2010, 21(1):122-8.
  19. Galindo-Moreno, P. Effect of anorganic bovine bone to autogenous cortical bone ratio upon bone remodeling patterns following maxillary sinus Clin Oral Implants Res. 2011, 22(8):857-64.
  20. Gapski R, Misch C, Stapleton D, Mullins S, Cobb C, Vansanthan A, Reissner M. Histological, histomorphometric, and radiographic evaluation of a sinus augmentation with a new bone allograft: a clinical case report. Implant Dent. 2008, 17(4):430-8.
  21. Garg AK, Qui?ones CR. Augmentation of the maxillary sinus: a surgical technique. Pract Periodontics Aesthet Dent. 1997, 9(2):211-9.
  22. Garg AK. Augmentation grafting of the maxillary sinus for placement of dental implants: anatomy, physiology and procedures. Implant Dent. 1999, 8(1):36-46.
  23. Geiger S, Pesh H. Animal and experimental studies of the healing around ceramic implants in bone lesion in the maxillary sinus region. Atsch Zahn?rtzl Z. 1977, 32(5):37:396.
  24. Gonshor A, McAllister BC, Wallace SS, Prasad H. Histologic and histomorphometric evaluation of an allograft stem cell- based matrix sinus augumentation procedure. Int J Oral Maxillofac Implants. 2011, 26:123-31.
  25. Haas R, Baron M, Donath K, Zechner W, Watzek G. Porous hydroxiapatite for grafting the maxillary sinus: a comparative histomorphometric study in sheep. Int J Oral maxillofac Implants. 2002, 17(3):337-46.
  26. Hatano, N, Shimizy Y, Ooya K. A clinical long-term radiographic evaluation of graft height changes after maxillary sinus floor augmentation with a 2:1 autogenous bone/xenograft mixture and simultaneous placement of dental implants. Clin Oral Implants Res. 2004, 15(3):339-45.
  27. He L, Chang X, Liu Y. Sinus floor elevation using osteotome technique without grafting materials: a 2-year retrospective study. Clin Oral Impl Res. 2011, 1:5.
  28. Horowitz RA. The use of osteotomes for sinus augmentation at the time of implant placement. Compend Contin Educ Dent. 1997, 18(5):441-51.
  29. H?rzeller MP. Reconstruction of severely resorbed maxilla with implants in the augmented maxillary sinus: 5 years clinical investigation. Int J Oral Maxillofac Implants. 1996, 11(4):466-75.
  30. Iizuka T, Smolka W, Hallermann W, Mericske-Stern R. Extensive augmentation of the alveolar ridge using autogenous calvarial split bone grafts for dental rehabilitation. Clin Oral Implants Res. 2004, 15(5):607-15.
  31. Jensen J, Sindet-Pedersen S, Oliver AJ. varyung treatment strategies for reconstruction of maxillary atrophy with implants: results in 98 patients. J Oral Maxillofac Surg. 1994, 52(3):210-6.
  32. Jensen OT, Greer RO, Jr Johnson L, Kassebaum D. Vertical guided bone-graft augmentation in a new canine mandibular model. Int J Oral Maxillofac Implants. 1995, 10(3):335-44.
  33. Jensen, T; Schou, S; Stavropoulos, A; Terheyden, H; Holmstrup, P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft in animals: a systematic review. Int J Oral Maxillofac Surg, 41(1):114-20, 2012.
  34. Jensen, OT. Volumetric changes of the graft after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios: a radiographic study in minipigs. Clin Oral Implants Res. 2012, 23(8):902-10.
  35. John HD, Wenz B. Histomorphometric analysis of natural bone mineral for maxillary sinus augmentation. Int J Oral Maxillofac Implants. 2004, 19(2):199-207.
  36. Kahnberg KE, Rasmusson L, Zellin G. Bone Grafting Techniques for Maxillary Implants. 1st edn Denmark: Blackwell Munksgaard. 2005, 33-4.
  37. Kaufman E. Maxillary sinus elevation surgery: an overview. J Esthet Restor Dent. 2003, 15(5):272-83.
  38. Keller EE, Eckert SE, Tolman DE. Maxillary antral and nasal one-stage inlay composite bone graft: preliminary report on 30 recipient sites. J Oral Maxillofac Surg. 1994, 52(5):438-47.
  39. Kent JN, Block MS. Simultaneous maxillary sinus floor bone grafting and placement of hydroxyapatite-coated implants. J Oral Maxillofac Surg. 1989, v.47.
  40. Krennmair G, Krainh?fner M, Maier H, Weinl?nder M, Piehslinger E. Computerized tomography-assisted calculation of sinus augmentation volume. Int J Oral Maxillofac Implants. 2006, 21(6):907-13.
  41. Lazzara RJ. The sinus elevation procedure in endosseous implant therapy. Curr Opin Periodontol. 1996, 3:178-83.
  42. Lee J, Susin C, Rodriguez NA, de Stefano J, Prasad HS, Buxton AN, Wikesj? UM. Sinus augmentation using rhBMP-2/ACS in a mini-pig model: relative efficacy of autogenous fresh particulate iliac bone grafts. Clin Oral Implants Res. 2012, 24(5):497-504.
  43. Lee, YM, et al. Bone reaction to bovine hydroxyapatite for maxillary sinus floor augmentation: histologic results in humans. Int J Periodontics Restorative Dent. 2006, 26(5):471-81.
  44. Lozada JL, Emanuelli S, James RA, Boskovic M, Lindsted K. Root-form implants placed in subantral grafted sites. J Calif Dent Assoc. 1993, 21(1):31-5.
  45. Magini RS, Oliveira OMR, Vasconcellos DK. Acesso atraum?tico ao seio maxilar. In. MAGINI, RS et al. Enxerto ?sseo no Seio Maxilar: Est?tica e Fun??o. S?o Paulo: Santos, 2006. p.185-217.
  46. Marei MK, Saad MM, El-Ashwah AM, El-Backly RM, Al-Khodary MA. Experimental formation of periodontal structure around titanium implants utilizing bone marrow mesenchymal stem cells: a pilot study. Journal of Oral Implantology. 2009, 35(3):106-29.
  47. Matos JDM, Santos IKS, Pereira ALC, Oliveira AJAG, Vasconcelos BCG, Neto ICP, Vasconcelos JEL. The use of the rich fibrin in platelets and leukocytes as alternative treatment for lifting the maxillary sinus - A Literature Review. International Journal of Development Research. 2017(07): 13436-13441.
  48. Misch CE. Bone character: second vital implant criterion. Dent Today. 1988, 7:39-40.
  49. Mordenfeld A. Histological and histomorphometrical analyses of biopsies harvested 11 years after maxillary sinus floor augmentation with deproteinized bovine and autogenous bone. Clin Oral Implants Res. 2010, 21(9):961-70.
  50. Nevins M. The clinical and histologic efficacy of xenograft granules for maxillary sinus floor augmentation. Int J Periodontics Restorative Dent. 2011, 31(3):227-35.
  51. Orsini G, Traini T, Scarano A, Degidi M, Perrotti V, Piccirilli M, Piattelli A. Maxillary sinus augmentation with Bio-Oss particles: a light, scanning, and transmission electron microscopy study in man. J Biomed Mater Res B Appl Biomater. 2005, 74(1):448-57.
  52. ?zkan Y. Maxillary sinus floor augmentation using bovine bone grafts with simultaneous implant placement: a 5-year prospective follow-up study. Implant Dent. 2011, 20(6):455-9.
  53. Ozyuvaci H, Bilgi B, Firatli E. Radiologic and histomorphometric evaluation of maxillary sinus grafting with alloplastic graft materials. J Periodontol. 2003, 74(6):909-15.
  54. Piattelli, MA. Bone reactions to anorganic bovine bone (Bio-Oss) used in sinus augmentation procedures: a histologic long- term report of 20 cases in humans. Int J Oral & Maxillofac Implants. 1999, 14(6):835-40.
  55. Pikd?ken L, G?rb?zer B, K???kodacı Z, Urhan M, Barış E, Tezulaş E. Scintigraphic, histologic, and histomorphometric analyses of bovine bone mineral and autogenous bone mixture in sinus floor augmentation: a randomized controlled trial--results after 4 months of healing. J Oral Maxillofac Surg. 2011, 69(1):160-9.
  56. Ribeiro FV. Peri-implant reconstruction using autologous periosteum- derived cells and guided bon? regeneration. J Clin Periodontol. 2010, 37:1128-36.
  57. Sauerbier S. Mesenchimal stem cells and bovine bone mineral in sinus lift procedures ? an experimental study in sheep. Tissue Eng Part C Methods. 2010, 16(5):1033-9.
  58. Srouji S, Ben-David D, Lotan R, Riminucci M, Livne E, Bianco P. The innate osteogenic potential of the maxillary sinus (Schneiderian) membrane: an ectopic tissue transplant model simulating sinus lifting. Int J Oral Maxillofac Surg. 2010,39(8):793-801.
  59. Pikos MA. Buccolingual expansion of maxillary ridge. Dental Implantology Update. 1992, 3(11):85-7.
  60. Raghoebar GM, Brouwer TJ, Reintsema H, Van Oort, RP. Augmentation of the maxillary sinus floor with autogenous bone for the placement of endosseous implants: a preliminary report. J Oral Maxillofac Surg. 1993, 51(11):1198-203.
  61. Reiser GM. Evaluation of maxillary sinus membrane response following elevation with the cristal osteotome technique in human cadavers. Int J Oral Maxillofac Implants. 2001, 16(6):833-40.
  62. Rissolo AR, Bennett J. Bone grafting and its essencial role in implant dentistry. Dental Clinics of North America. 1998, 42(1):91-115.
  63. Rosen MD, Sarnat BG. Change of volume of the maxillary sinus of the dog after extraction of adjacent teeth. Oral Surg Oral Med Oral Pathol. 1995, 8:420-9.
  64. Sakka S, Krenkel C. Simultaneous maxillary sinus lifting and implant placement with autogenous parietal bone graft: outcome of 17 cases. J Craniomaxillofac Surg. 2011, 39(3):187-91.
  65. Santler G, Kaercher H, Gaggl A, Schultes G. Application of combined three-dimensional bone and soft tissue model. A case report. Int J Oral Maxillofac Surg. 1998, 27(6):482-4.
  66. Sauerbier S, Stubbe K, Maglione M, Haberstroh J, Kuschnierz J, Oshima T, Xavier SP, Brunnberg L, Schmelzeisen R, Gutwald R. Mesenchymal stem cells and bovine bone mineral in sinus lift procedures - an experimental study in sheep. Tissue Eng Part C Methods. 2010, 16(5):1033-9.
  67. Sbordone C, Sbordone L, Toti P, Martuscelli R, Califano L, Guidetti F. Volume changes of grafted autogenous bone in sinus augmentation procedure. J Oral Maxillofac Surg.2011, 69(6):1633-41.
  68. Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol. 2004, 75(4):511-6.
  69. Sicca CM. Comparative histomorphometric and tomographic analysis of maxillary sinus floor augmentation in rabbits using autografts and xenografts.J Biomed Mater Res B Appl Biomater. 2008, 86(1):188-96.
  70. Small SA, Zinner ID, Panno FV, Shapiro HJ, Stein JI. Augmenting the maxillary sinus for implants: report of 27 patients. Int J Oral Maxillofac Implants. 1993, 8(5):523-8.
  71. Smiler DG, Holmes RE. Sinus lift procedure using porous hydroxyapatite: a preliminary clinical report. J Oral Implantol. 1987, 13(2):239-53.
  72. Soltan M, Smiler DG. Antral membrane balloon elevation. J Oral Implantol. 2005, 31(2):85-90.
  73. Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compend Contin Educ Dent. 1994, 15(2):152-60.
  74. Summers RB. The osteotome technique: part 4 - Future site development. Compend Contin Educ Dent. 1995, 16(11):1090-8.
  75. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin North Am. 1986, 30:207-29.
  76. Tidwell JK, Blijdorp PA, Stoelinga PJ, Brouns JB, Hinderks F. Composite grafting of the maxillary sinus for placement of endosteal implants. A preliminary report of 48 patients. Int J Oral Maxillofac Surg. 1992,21(4):204-9.
  77. Timmenga NM, Raghoebar GM, Boering G, van Weissenbruch R. Maxillary sinus function after sinus lifts for the insertion of dental implants. J Oral maxillofac Surg. 1997, 55(9):936-9.
  78. Timmenga NM, Raghoebar GM, van Weissenbruch R, Vissink A. Clin Oral Implants Res. 2003, 14(3):322-8.
  79. Van den Bergh JP, ten Bruggenkate CM, Krekeler G, Tuinzing DB. Sinusfloor elevation and grafting with autogenous iliac crest bone. Clin Oral Implants Res. 1998, 9(6):429-35.
  80. Traini T. A histologic and histomorphometric evaluation of anorganic bovine bone retrieved 9 years after a sinus augmentation procedure. J Periodontol. 2007, 78(5):955-61.
  81. Wallace SS, Froum SJ, Tarnow DP. Histologic evaluation of a sinus elevation procedure: a clinical report. Int J Periodontics Restorative Dent. 1996, 16(1):46-51.
  82. Wallace SS, Froum SJ, Cho SC, Elian N, Monteiro D, Kim BS, Tarnow DP. Sinus augmentation utilizing anorganic bovine bone (Bio-Oss) with absorbable and nonabsorbable membranes placed over the lateral window: histomorphometric and clinical analyses. Int J Periodontics Restorative Dent. 2005, 25(6):551-9.
  83. Woo I, Le BT. Maxillary sinus floor elevation: review of anatomy and techniques. Implant Dent. 2004, 13(1): 28-32.
  84. Wood RM, Moore DL. Grafting of the maxillary sinus with intraorally harvested autogenous bone prior to implant placement. Int J Oral Maxillofac Implants. 1988, 3(3):209-14.
  85. Zijderveld SA, Zerbo IR, Van DenBergh JP, Schulten EA, ten Bruggenkate CM. Maxillary sinus floor augmentation using a beta-tricalcium phosphate (Cerasorb) alone compared to autogenous bone grafts. J Oral Maxillofac Implants. 2005, 20:432?40.
  86. Zizelmann C, Schoen R, Metzger MC, Schmelzeisen R, Schramm A, Dorr B, Bormann KH, Gellrich NC. Bone formation after sinus augmentation with engineered bone. Clin Oral Impl Res. 2007, 18:69-73.

[Jozely Francisca Mello Lima, Jefferson David Melo de Matos, ?talo Kennedy Silva Santos, Antonio Jackson Andrade Gonzaga de Oliveira, John Eversong Lucena de Vasconcelos, Lucas Villa?a Zogheib and Daniel Sartorelli de Castro. (2017); MAXILLARY SINUS LIFT SURGERY TECHNIQUES: A LITERATURE REVIEW. Int. J. of Adv. Res. 5 (Aug). 832-844] (ISSN 2320-5407). www.journalijar.com


John Eversong Lucena de Vasconcelos
Professor of Oral Implantology, DepartmentofDentistry, Centro Caririense de Pós-Graduação CECAP, Juazeiro do Norte – CE, Brazil.

DOI:


Article DOI: 10.21474/IJAR01/5126      
DOI URL: http://dx.doi.org/10.21474/IJAR01/5126