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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, with American surgeon Oscar Hilt Tatum first presenting it at professional conferences in 1974. The first scientific publication dates back 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. Several years later, in 1994, Summers proposed a less invasive approach using a crestal route with osteotomes. Since then, the development of biomaterials and minimally invasive techniques has considerably improved the predictability and comfort of this procedure, which is now essential in oral implantology.
The sinus lift (or sinus floor elevation) is a surgical procedure designed to increase the bone height of the posterior maxilla. This procedure involves lifting the sinus membrane and inserting a biomaterial to promote bone regeneration. The ultimate goal is to obtain sufficient bone volume for dental implant placement, ensuring optimal primary stability and long-lasting rehabilitation.
As previously mentioned in the history of sinus lifts, there are two possible surgical techniques. In most cases, the choice of technique will be guided by the available bone height 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 sinus lift technique |
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 between 3 and 6 mm |
| Possible bone gain | Significant (suited to severe deficits) | Moderate (suited to intermediate cases) |
| Invasiveness | More invasive (lateral window) | Less invasive (via 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 the event of perforation |
| Implant placement | Rarely possible in a single procedure | Often possible in a single procedure |
In summary: the lateral approach is better suited to complex cases with marked bone deficiency, while the crestal approach is preferred for moderate cases due to its greater simplicity.
For sinus lifts, as in implantology, several types of bone grafts can be used depending on the 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 procedure time. They offer an unlimited quantity of grafts and good osteoconductive properties. However, unlike autografts (grafts taken from the recipient patient), they do not possess osteogenic properties, and their use is subject to specific regulations, distinct from those governing medical devices.
Xenografts, derived from animal bone, share some similar advantages: no additional harvesting, reduced surgical time and unlimited availability. Furthermore, they are classified as medical devices. However, they do not possess osteogenic properties and are relatively unremodelable, which can limit their complete integration.
Finally, laboratory-produced synthetic bone substitutes are a reliable and cost-effective alternative. They eliminate the need for a second surgical site, reduce the procedure time and offer an unlimited supply of grafts, with the added advantage of a relatively low cost and their status as medical devices. Their limitations lie in the lack of osteogenic properties and results that are sometimes less predictable than those obtained with other types of grafts.
Studies show implant survival rates exceeding 95% after a sinus lift, comparable to implants placed in native bone. The prognosis is excellent when proper planning, biomaterial selection and surgical technique are followed.
