Osteotome Sinus Floor Elevation Technique without Grafting Material and Immediate Implant Placement in Atrophic Posterior Maxilla: Report of 2 Cases

Purpose: This case report discusses 2 patients who required implant placement in the atrophic posterior maxilla to support a fixed prosthesis with the least invasive and shortest procedure. Materials and Methods: The reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach with delayed implant placement. However, in these cases, the posterior maxillas were treated with an osteotome sinus floor elevation procedure without grafting material and simultaneous placement of short, 8- and 10-mm-long, tapered implants. Results: All implants achieved primary stability and were successfully loaded after 3.6 months of healing. At the 1- and 2-year follow-up visits, they were clinically stable and the final prostheses were functioning. The mean endosinus bone gain was 5.1 +/- 1.3 mm. In 1 of the patients, the implants were completely embedded in the newly formed bone and the sinus floor had been relocated apical to its previous demarcation. Conclusions: The findings from these 2 cases suggest that the osteotome sinus floor elevation procedure without grafting material, and immediate placement of tapered implants, might be applied in situations for which previously only the lateral approach was considered (at the condition that implants achieve firm primary stability). More patients and longer follow-up are warranted to investigate how reliable this technique can be when applied to the atrophic maxilla. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1098-1103, 2009