Endoscope-Controlled Maxillary Sinus Floor Elevation via a Mini-Lateral Window

Objectives: This study evaluated the effectiveness and safety of endoscope-controlled maxillary sinus elevation via a mini-lateral window with simultaneous placement of implants in patients with severely atrophic maxilla.
Methods: Six patients were enrolled in this study, receiving maxillary sinus elevation by a lateral approach via a 3 mm-diameter mini-round lateral osteotomy and simultaneous implant placement. The sinus membrane was gently detached during the surgery, and the endoscope was inserted into the subantral space below the membrane to visualize the augmentation site. After the sinus membrane was basically lifted, the implant sockets were prepared. Then, the sinus membrane was further lifted, and the graft was placed precisely under endoscope observation through the lateral window or the alveolar crest. Alveolar bone height was measured preoperatively (baseline), immediately after the procedure (T1), and 6 months (T2) postoperatively based on cone-beam computed tomography (CBCT). Intraoperative and postoperative complications were recorded.
Results: A total of six sinuses were lifted, and eight implants were placed. The mean residual alveolar bone height was 4.24 ± 1.24 mm. Immediate and 6-month postoperative alveolar bone height was 13.18 ± 2.31 and 12.68 ± 2.22 mm, respectively. The resorption rate of the augmented bone height 6 months after elevation was 5.50%. Mean bone density values below the lifted sinus membrane immediate postoperative was 1544.74±122.61 gray values (GVs) and increased to 1884.10±187.60 gray values (GVs) 6 months later (P<0.05). Within 1 year of follow-up, the cumulative survival rate of implants was 100%.
Conclusions: Endoscope-controlled maxillary sinus elevation via a mini-lateral window with simultaneous placement of implants is a non-invasive method with a low failure rate, enabling the surgeon to lift the maxillary sinus floor under direct vision and place graft materials more accurately.