Nasser Al Alami*

Specialist Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, EHS, UAE

*Corresponding Author: Nasser Al Alami, Specialist Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, EHS, UAE.

Received: November 12, 2025; Published: December 16, 2025

Abstract

The posterior maxilla often presents challenges for implant placement due to limited bone height and ridge width, which may require augmentation techniques. The crestal approach sinus lift, first described by Summers (1994), is a minimally invasive alternative to the lateral window technique, reducing postoperative morbidity while maintaining successful outcomes. However, in cases with both insufficient vertical and horizontal bone dimensions, bone splitting can be combined with the crestal approach to expand the ridge and facilitate implant placement. Traditional Summers technique (internal sinus lifting) includes minimum sinus lifting of 2 to 3 mm. In our cases, the crestal approach technique was used to gain more than 5 mm height. In one of the cases, the technique is combined with ridge splitting to increase bone thickness as well.

Case Presentation: This report describes the surgical management of 3 patients presenting with severely resorbed maxillary ridges, where a combination of bone splitting and crestal sinus lift was performed in two of them. Implants are placed simultaneously, where primary stability is obtained. Clinical and radiographic follow-up demonstrated successful sinus augmentation, sufficient bone gain, and implant integration without complications and simple procedures.

Discussion: The combination of crestal approach sinus lifting and bone splitting in atrophic maxillary cases provides a minimally invasive alternative to traditional augmentation techniques. Unlike the lateral window approach, this technique minimises postoperative complications while achieving substantial vertical and horizontal bone gain. The use of Trephine burs and osteotomes allows controlled sinus elevation while preserving soft tissue integrity. Clinical follow-up demonstrated successful implant integration with no complications, reinforcing the efficacy of this approach in managing complex cases.

Conclusion: The combination of crestal sinus lift and bone splitting is a viable approach for managing atrophic posterior maxilla cases, allowing for ridge expansion and vertical bone gain in a single procedure. This minimally invasive technique preserves soft tissue integrity, reduces healing time, and enhances implant success rates. Further studies and long-term follow-ups are necessary to establish its predictability in complex cases.

Keywords: Dental Implant; Crestal Sinus Lifting; Ridge Splitting

References

1. M King E and Schofield “Restoratively driven planning for implants in the posterior maxilla - Part 1: alveolar bone healing, bone assessment and clinical classifications”. British Dental Journal 235.8 (2023): 585-592.
2. Sinha R., et al. “Lateral approach sinus (LAS) and crestal approach sinus (CAS): The unravelled paraphernalia for maxillary sinus membrane advancement”. Journal of Dental Specialities 11.1 (2023): 62-68.
3. Al-Dubai SAS., et al. “Comparison between Modified Bone-splitting Technique and Distraction Osteogenesis in Horizontal Alveolar Ridge Expansion: Randomized Clinical Study”. Journal of Contemporary Dental Practice 23.10 (2022): 1008–1015.
4. Lyu M., et al. “Maxillary sinus floor augmentation: a review of current evidence on anatomical factors and a decision tree”. International Journal of Oral Science 15 (2023):
5. Stacchi C., et al. “Minimally Invasive Management of Implant-Supported Rehabilitation in the Posterior Maxilla, Part II. Surgical Techniques and Decision Tree”. The International Journal of Periodontics and Restorative Dentistry 40 (2020).
6. MG Tissiani., et al. “Prf-enhanced maxillary sinus lift”. Adson, Health Sciences 29 (2024).
7. Pjetursson BE and Lang NP. “Sinus floor elevation utilizing the transalveolar approach”. Periodontalogy 2006 66.1 (2014): 59-

Citation

Citation: Nasser Al Alami. “Managing Severe Maxillary Resorption with Crestal Approach Sinus Lifting and Immediate Dental Implants 3 Case Report".Acta Scientific Dental Sciences 10.1 (2026): 08-14.

Copyright

Copyright: © 2026 Nasser Al Alami. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.