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The sinus lift technique increases the available bone height and ensures the placement of stable and durable implants.
In the posterior region of the maxilla, the placement of dental implants is often compromised by insufficient bone volume, linked to pneumatisation of the maxillary sinus and post-extraction bone resorption.
The sinus lift technique emerged in the 1970s thanks to American surgeon Oscar Hilt Tatum, who first presented it at professional conferences in 1974. The first scientific publication dates to 1980, when Boyne and James described a sinus graft using autogenous bone (J Oral Surg). In 1986, Tatum officially published his method in Dental Clinics of North America, marking its entry into international clinical practice. A few years later, in 1994, Summers proposed a less invasive crestal approach using osteotomes. Since then, advances in biomaterials and minimally invasive techniques have significantly improved the predictability and comfort of this procedure, which is now essential in oral implantology.
A sinus lift is a surgical procedure aimed at increasing the bone height of the posterior maxilla. This procedure involves lifting the sinus membrane and inserting a biomaterial to promote bone regeneration. The goal is to obtain sufficient bone volume for the placement of dental implants, ensuring optimal primary stability and long-lasting rehabilitation.
As mentioned earlier in the history of sinus lifts, there are two possible surgical techniques. In most cases, the choice of the technique will be guided by the amount of bone available for implant placement.
 |
 |
 |
 |
|
| Available bone height | > 8 mm | From 6 to 8 mm | From 3 to 6 mm | < 3 mm |
| Possible technique | Implant placement without the need of grafting | Atraumatic apex implant placement possible | Crestal sinus lift technique (Summers technique) | Lateral approach |
Figure 1 : Example of a possible decision tree for choosing a sinus lift technique
Lateral sinus lift (Tatum, 1986)
Crestal sinus lift (Summers, 1994)
Advantages and disadvantages of these two techniques
| Criteria | Lateral approach | Summers technique |
| Main indication
|
Residual bone height is < 3 mm | Residual bone height is between 3 and 6 mm |
| Possible bone gain | Significant (suitable for severe defects) | Moderate (suitable for intermediate cases) |
| Invasiveness | More invasive (lateral window) | Less invasive (through the implant site) |
| Operating time | Longer | Shorter |
| Risk of complications | Higher risk of sinus membrane perforation but significant visibility | Lower risk, but limited indications and membrane not visible in case of perforation |
| Implant placement | Rarely possible in one stage | Often possible in one stage |
In summary: the lateral approach is more suitable for complex cases with significant bone deficiency, while the crestal approach is preferred for moderate situations due to its greater simplicity.
For sinus lifts, as in implantology, several types of bone grafts can be used depending on clinical indications and the practitioner’s needs.
Allografts, derived from treated and virus-inactivated human bone, have the advantage of not requiring a second surgical site, thus reducing the duration of the procedure. They offer an unlimited supply of grafts and good osteoconductive properties. However, unlike autografts (grafts taken from the recipient patient), it does not have osteogenic properties and its use is subject to specific regulations that are distinct from those governing medical devices.
Xenografts, derived from animal bone, share some similar advantages: no additional harvesting, reduced surgical time and unlimited availability. In addition, they benefit from medical device status. However, they do not have osteogenic properties and remain poorly remodellable, which can limit their complete integration.
Finally, synthetic bone substitutes, produced in laboratories, represent a reliable and economical alternative. They avoid the need for a second surgical site, reduce the duration of the procedure and offer an unlimited quantity of grafts, with the added advantage of relatively low cost and their status as medical devices. Their limitations lie in their lack of osteogenic properties and results that are sometimes less predictable than those obtained with other types of grafts.
Studies show implant survival rates of over 95% after sinus lift, comparable to implants placed in native bone. The prognosis is excellent when planning, biomaterial selection and surgical technique are followed correctly.
