Implant Placement in the Low Sinus: Critical Analysis of Available Techniques

Sunday Session, 2:30–5 p.m.
Program Track: Implants

Moderator: Barry D. Wagenberg
Speakers: Ziv Mazor and Michael Toffler

The lateral window osteotomy (LWO) has been the most frequently utilized and published approach to sinus augmentation, presumably because there are no bone height restrictions and it provides the surgeon with more visual control; it is, however, considered to be invasive, time consuming, expensive, and associated with patient morbidity. As a less invasive alternative to the LWO, transcrestal osteotome, balloon and hydrodynamic techniques can obtain a localized elevation of the sinus floor through a two to seven mm diameter crestal osteotomy, minimizing the degree of flap elevation and eliminating the need for preparation of a larger bony window in the lateral aspect of the alveolus. Procedural modifications, innovative instrumentation, autologous growth factors, and preoperative CBCT analysis have made both approaches to Sub Antral Floor elevation safer, faster, simpler, and more predictable. However, confusion and disagreement persists over when to use which approach as well as the limitations and risks of both. These two experienced clinicians and researchers will present their creative approaches to successful management of reduced subantral bone height, sharing procedural modifications and the newest instrumentation designed to improve the clinical experience for both the doctor and patient.

Educational Objectives:
• Explain the influence on procedural selection and outcome for sinus anatomy/CBCT analysis.
• Apply minimization and “outside the box” thinking and solutions to management of common intra- and postoperative complications.
• Assess whether autologous and recombinant growth factors help or are just hype.
• Identify whether particulate grafts are needed and, if so, when and which?
• Achieve optimal results by utilizing modern instrumentation such as piezo bone surgery devices, osseodensification and dedicated balloon.