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Internal (osteotome crestal) approach
External (lateral window) approach
This is a procedure used in cases where there is not enough height and width of bone in the upper jaw to place an implant. A part of the sinus cavity is then used, in which a bone graft is placed. This serves as a scaffold for new bone to mature, and after 6 months, the implant can be placed.
Definitely yes, because there is always a waiting time, usually 4-6 months. Additionally, it has a higher cost because, apart from the complexity of the procedure, it requires a relatively large amount of graft material to fill the sinus cavity that will be used for implant placement.
Success rates in recent years are very high. It is, therefore, a predictable procedure with a good prognosis. However, it should be noted that it requires a longer recovery time, higher costs, and a longer healing time.
Like any surgical procedure, it requires careful planning, diagnosis, and execution. There are reports of complications and problems, so a conservative approach would be to exhaust all possibilities of more conventional interventions for implant placement.
First alternative is very short implants (up to 4mm). In this case, a greater number of implants will be required for biomechanical reasons.
Second alternative is the diagonal or tilted implant, which also has a high success rate in the literature.
Third alternative is closed sinus lift, i.e., a limited (2-3mm) increase of the existing bone, but without the invasiveness of an open sinus lift procedure.