Clinical Evaluation of Modified Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: A Retrospective Randomized Controlled Study

Clinical Evaluation of Modified Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: A Retrospective Randomized Controlled Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Evaluation of Modified Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: A Retrospective Randomized Controlled Study Fengtong Liu, Fang Yuan, Tengfei Li, Wanggui Ying, Jianliang Shan, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7527675/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 19 Feb, 2026 Read the published version in BMC Oral Health → Version 1 posted 14 You are reading this latest preprint version Abstract Objective This study aimed to evaluate the clinical efficacy and reliability of an improved maxillary sinus floor elevation technique when applied to cases with severe bone deficiency in the posterior maxillary region, with simultaneous implant placement. Methods A total of 64 edentulous patients with maxillary bone deficiencies were enrolled in this study. Of these, 34 underwent the improved maxillary sinus floor elevation technique combined with immediate implant placement, while the remaining 30 received the conventional bone chisel technique also followed by simultaneous implant placement. Radiological and clinical assessments were performed to comprehensively evaluate the practical applicability of the improved technique and compare its osteogenic outcomes with those of the conventional method. Results The mean increase in maxillary bone height was 6.016 ± 1.312 mm in the improved technique group and 2.797 ± 0.898 mm in the conventional bone chisel group, with a statistically significant difference (P < 0.001). The bone coverage at the apical portion of the implant was significantly greater in the improved technique group both immediately post-surgery and 6–10 months after the procedure (P < 0.001). Similarly, the perimplant bone condition in the improved technique group showed statistically significant improvement compared to the conventional technique at both time points (P < 0.001). No significant differences were observed in short-term implant survival and success rates between the two groups. Notably, no complications such as maxillary sinus membrane perforation or postoperative symptoms including headache, dizziness, or discomfort were reported in the improved technique group. Conclusion The improved maxillary sinus floor elevation technique demonstrates favorable clinical outcomes for patients with insufficient posterior maxillary bone height, particularly in cases where the residual height is less than 5 mm. Although no significant differences were found in short-term implant success and survival rates, the improved technique offers enhanced bone augmentation and reduced complication risks. Maxillary Sinus Floor Elevation Bone Augmentation Dental Implants Bone Substitute Materials Residual Bone Height Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction With the continuous advancement of medical technology and an increasing patient focus on masticatory function and oral health, dental implant restoration has become a more commonly chosen option for individuals with missing teeth. Following the loss of posterior maxillary teeth, the absence of muscular attachment stimulation combined with the effects of negative pressure during respiration can lead to maxillary sinus pneumatization. This process results in a gradual thinning of the maxillary sinus bone wall and ultimately causes a reduction in the remaining bone height (RBH) in the posterior maxillary region. Furthermore, factors such as periodontitis, periapical inflammation, long-term alveolar ridge atrophy and resorption after tooth loss, as well as congenital underdevelopment of the posterior maxilla, can significantly compromise the available bone height. To address maxillary sinus pneumatization accompanied by alveolar bone resorption, maxillary sinus floor elevation has become a widely adopted clinical technique. Currently, two primary surgical approaches are employed in clinical practice: external maxillary sinus elevation and internal maxillary sinus elevation. [1,2] There is no doubt that the external sinus lift procedure tends to cause greater trauma and impose a higher economic burden on patients [3,4,5] . Maxillary sinus floor elevation (MSFE) is a surgical technique that involves lifting the mucosa of the maxillary sinus floor via the alveolar ridge in order to create space for new bone formation. This procedure satisfies the minimum bone volume requirements necessary for implant placement, thereby expanding the indications for implant-supported restoration in the posterior maxillary region. In recent years, researchers have been actively investigating methods to effectively reduce operative time, minimize postoperative discomfort, and alleviate the financial burden on patients. With continuous advancements in clinical techniques, medical devices, and biomaterials, bone augmentation strategies associated with the internal sinus lift procedure are also continuously evolving. The aim is to preserve a greater amount of native bone at the maxillary sinus floor while achieving adequate space for successful bone grafting [6,7,8] . To preserve a greater amount of bone at the maxillary sinus floor, ensure adequate space for bone graft materials and implant placement, and minimize postoperative discomfort, we assessed the short-term clinical efficacy and reliability of a modified combined technique involving the use of a bone chisel and SCA-KIT instruments for maxillary sinus floor elevation and simultaneous implant insertion in patients with insufficient vertical bone height in the posterior maxillary region, in comparison with the conventional bone chisel method. Materials and Methods This study on modified sinus floor elevation via the alveolar crest was conducted in strict accordance with the ethical principles outlined in the World Medical Association’s Declaration of Helsinki. It has been formally reviewed and approved by the Ethics Committee of Jinan Stomatological Hospital, Shandong Province, China (Approval No.: JNSKQYY-2025-014). All participants provided written informed consent after receiving a comprehensive explanation of the research objectives, procedures, and potential risks involved. This study enrolled a total of 64 patients (64 implants; 33 females and 31 males) who were scheduled to undergo maxillary sinus floor elevation via the alveolar crest approach between January 2023 and July 2025, with a follow-up duration ranging from 1 to 2 years. The mean age of the participants was 50 years, with an age range of 26 to 75 years. Instruments and Materials: Internal lifting tool SCA-KIT (South Korea), External lifting tool DASK-Dentium (South Korea), bone extruder (South Korea), bone substitute material—Bio-Oss bone powder (produced by Geistlich Pharma AG, Switzerland), periosteal membrane—HaiAo Oral Repair Membrane (manufactured by Yantai Zhenghai Bio-Technology Co., Ltd.), CGF (Concentrated Growth Factor), prepared from the patient's autologous blood by a trained nurse using the DU LING JLC-I device)（Figure 1）, and Collagen Sponge (Beiling, produced by Beijing Yierkang Bio-Engineering Co., Ltd.). Dental implants ： Straumann、OSSTEM and Astra Inclusion criteria were as follows: 1) presence of at least one missing maxillary posterior tooth; 2) residual bone height (RBH) in the maxillary posterior region of ≥ 2 mm and < 10 mm; 3) completion of the final prosthesis installation; 4) maintenance of good oral hygiene and periodontal health, defined as no sites with bleeding on probing (BOP) and probing depths (PD) not exceeding 4 mm. Exclusion criteria included: 1) systemic contraindications such as uncontrolled diabetes, hypertension, coagulation disorders, or other conditions affecting general health; 2) local contraindications such as uncontrolled periodontitis, maxillary sinusitis, maxillary osteomyelitis, or other local inflammatory conditions; 3) heavy smoking, defined as consumption of 10 or more cigarettes per day. The Procedure of Modified Internal Lifting Surgery The patient should follow the instructions to rinse the mouth with compound chlorhexidine mouthwash for approximately three minutes prior to the procedure. The skin from the infraorbital region to the submandibular and neck areas should be disinfected using iodophor disinfectant solution, followed by the application of sterile dressings. At the commencement of the procedure, local anesthesia is administered via an injection of articaine hydrochloride and epinephrine (Novocol Pharmaceutical of Canada Inc.). Subsequently, an incision is made along the alveolar ridge, and full-thickness mucoperiosteal flaps on both the buccal and palatal sides are elevated to fully expose the implant site. Concurrently, blood samples are collected using a syringe. First, a ball drill is used to determine the initial positioning. Subsequently, a preliminary probe drill equipped with a stop ring is employed to drill to a depth of approximately 0.5–1 mm below the sinus floor. Next, the SCA drill is utilized to gradually prepare the cavity to a depth of approximately 0.5–1 mm below the sinus floor. If the bone at the sinus floor is relatively dense, the cavity may be prepared to within 0.5 mm below the sinus floor. Once the implant site has reached the desired width, the sinus floor is gently tapped using a convex bone chisel to create a greenstick fracture and slight protrusion. Thereafter, the largest SCA drill is used to separate the protruding sinus floor bone from the surrounding sinus mucosa. A separator is then employed to carefully elevate the sinus mucosa around the cavity. Using a convex bone chisel that matches the shape of the cavity, the sinus membrane is lifted by approximately 1–2 mm. This is followed by the use of various separators (DASK) to gradually separate the adjacent sinus membranes. Upon completion of the separation, a secondary elevation of the sinus membrane is performed to ensure sufficient height for implant placement. Finally, a depth gauge is used to assess the elevation of the sinus membrane, and the integrity of the sinus membrane is confirmed via the Valsalva maneuver. (Figure 3) To prevent rupture or perforation of the maxillary sinus mucosa during the elevation procedure, a stepwise mucosal separation technique was employed for cases with thinner sinus membrane. Specifically, the sheet-like collagen sponge was cut into continuous strips and placed progressively in all directions after initial separation of the sinus floor mucosa, thereby elevating the membrane to the desired height(Figure 2). Concurrently, CGF (Concentrated Growth Factor) membranes were prepared from autologous blood and placed at the sinus floor to minimize the risk of mucosal perforation. Additionally, a bone substitute material (Bio-Oss) was thoroughly mixed with autologous blood and carefully packed into the space beneath the elevated sinus membrane to ensure stable grafting. Following the completion of the bone grafting procedure, an implant of standard length (≥8 mm) is positioned within the recipient site. If adequate primary stability (torque ≥ 25 N·cm) is attained, a healing abutment measuring 4 mm in height is affixed atop the implant. However, if the desired primary stability (torque < 25 N·cm) cannot be achieved or if a localized deficiency in the alveolar ridge necessitates additional bone grafting, the implant should be connected to a healing abutment with an increased diameter and a height of 2 mm. This ensures secure fixation of the implant within the cortical bone. Finally, the mucoperiosteal flap is sutured tightly to complete the procedure. Postoperative Management All patients underwent cone-beam computed tomography (CBCT) following surgery to confirm the precise position of the implant, the height of newly formed bone surrounding the implant, the mucosal elevation level, and the extent of flap mobilization. Starting on the day of surgery, all patients received a prophylactic anti-inflammatory regimen consisting of metronidazole and amoxicillin for a duration of 3 to 5 days. Sutures were removed on postoperative day 14. A healing period of 6 to 10 months was observed for all patients. Upon completion of the healing phase, CBCT imaging was performed again to evaluate the status of perimplant bone. In cases involving submerged implants, a second-stage surgical procedure was conducted. Data collection Postoperative follow-ups were scheduled at 2 weeks, 1 month, 6–10 months, and 1–2 years after surgery. A systematic evaluation and documentation were performed regarding the condition of the peri-implant bone and soft tissues, in accordance with the consensus of the World Workshop on Periodontal and Peri-implant Diseases and Conditions, as well as the patients’ subjective experiences. Based on CBCT imaging, the vertical bone height at the implant site was assessed. The specific measurement method was as follows: the distance from the alveolar crest to the lowest point of the maxillary sinus floor along the predetermined implant axis was defined as the remaining bone height; the distance from the alveolar crest to the elevated sinus membrane along the long axis of the implant was defined as the elevated bone height. The vertical bone increment was calculated as the difference between the remaining bone height and the elevated bone height (Figure 3G). Bone height measurements were performed twice using the same method—immediately after surgery and at 6–10 months postoperatively. Additionally, the bone height covering the apical end of the implant along its long axis was measured, including the distances from the bone planes at the mesial, distal, buccal, and palatal aspects of the implant to the apical reference plane. The extent of sinus membrane elevation was expressed as the angle formed between the line connecting the apical vertex of the implant and the edge point of the sinus membrane elevation and the long axis of the implant. All measurements were conducted three consecutive times by the same attending physician, and the median value was recorded for analysis. Baseline patient information. Mean ± SD or n(%) Clinical evaluation Throughout the surgical procedure and the postoperative recovery phase, comprehensive documentation was maintained regarding intraoperative complications, including sinus membrane perforation and hemorrhage, as well as postoperative complications such as facial swelling, maxillary sinusitis, headache, and dizziness. Implant success and survival rates In this study, the criteria for evaluating implant success include: (1) absence of clinical mobility of the implanted prostheses; (2) absence of radiographic evidence of peri-implant bone resorption on CBCT imaging; (3) absence of persistent pain, numbness, paresthesia, or other subjective symptoms reported by the patient; (4) absence of pathological conditions such as inflammation, bleeding, swelling, or suppuration in the peri-implant soft tissues; and (5) marginal bone loss (MBL) not exceeding 1.0 mm within the first year following implant loading [9] . Statistical methods: This study employed inferential statistical methods using IBM SPSS Statistics 26.0 software to analyze the data. To assess the average increase in bone height immediately after surgery, the height of bone covering the root end margin of the implant (both immediately after surgery and 6–10 months post-surgery), and the height of bone covering the axial root end of the implant (also measured at the two time points) between the two surgical techniques, the normal probability plot method was initially applied to determine whether the data followed a normal distribution. Subsequently, an F-test was conducted to evaluate the homogeneity of variances. Once the assumptions were satisfied, an independent samples t-test was performed for intergroup comparisons. The statistical analysis was conducted using a two-tailed test, with the significance level set at α = 0.05. Additionally, linear regression analysis was utilized to examine the relationship between the measurement angle size and the extent of sinus floor mucosa elevation. Results A total of 64 patients were enrolled in this clinical study, each receiving one implant following trans-sinus floor elevation (TSFE). All participants underwent TSFE and implant placement simultaneously. Among these patients, 34 individuals, requiring a bone height increase of more than 3 mm, underwent the combined use of the bone chisel and sinus crestal approach (SCA), and received both implants and bone grafting material (Bio-Oss). The remaining 30 patients required a greater vertical augmentation (more than 5 mm); these individuals agreed only to undergo maxillary sinus floor elevation and declined the use of bone grafting materials. In this subgroup, maxillary sinus elevation was performed using the conventional bone chisel technique alone. The imaging examination results indicate that All surgical procedures were successfully completed. Patients who underwent modified maxillary sinus floor elevation achieved the desired bone augmentation outcomes. The mean residual bone height prior to surgery was 4.771 ± 1.580 mm, with a mean increase in bone height of 6.016 ± 1.312 mm postoperatively. For patients treated with the osteotome technique, the mean preoperative residual bone height was 7.856 ± 1.367 mm, and the average postoperative increase in bone height was 2.797 ± 0.898 mm. The axial bone height covering the apical portion of the implant was assessed immediately postoperatively and at 6–10 months post-surgery. The mean values were 1.92 ± 0.81 mm and 0.51 ± 0.53 mm immediately postoperatively for the modified technique and the bone chisel method, respectively. At 6–10 months post-surgery, the corresponding values were 1.39 ± 0.67 mm for the modified method and 0.24 ± 0.36 mm for the bone chisel method, with statistically significant differences between the two techniques.( Figure 5C.D, Table 1) The bone height covering the apical margin of the implant was further analyzed at the same time points. Immediately postoperatively, measurements for the modified method were as follows: mesial 1.639 ± 0.942 mm, distal 1.689 ± 0.922 mm, buccal 1.625 ± 0.959 mm, and palatal 1.807 ± 0.718 mm. For the bone chisel method, the corresponding values were: mesial -0.296 ± 1.148 mm, distal -0.254 ± 1.046 mm, buccal -0.150 ± 1.021 mm, and palatal 0.003 ± 0.762 mm. At 6–10 months post-surgery, the measurements for the modified method were: mesial 0.997 ± 0.723 mm, distal 0.971 ± 0.665 mm, buccal 0.979 ± 0.801 mm, and palatal 1.062 ± 0.591 mm. For the bone chisel method, the respective values were: mesial -0.697 ± 1.140 mm, distal -0.650 ± 1.113 mm, buccal -0.293 ± 0.723 mm, and palatal -0.327 ± 0.732 mm. All intergroup comparisons revealed statistically significant differences. ( Figure 5A.B, Table 2.3) Additionally, the angle formed by the straight line connecting the apical vertex of the implant’s long axis and the mucosal separation point from the maxillary sinus floor, relative to the implant’s long axis, was measured immediately postoperatively. The mean angular values were: mesial 84.424 ± 22.677°, distal 79.159 ± 14.170°, buccal 94.635 ± 18.402°, and palatal 91.812 ± 15.198° for the modified technique. (Figure 6) In terms of intraoperative complications, two cases of sinus membrane perforation occurred in patients who underwent bone chisel elevation alone. Both perforations were less than 2mm in diameter. One case involved a more inclined maxillary sinus floor, while the other presented with a relatively flat and wide maxillary sinus floor accompanied by a thin sinus membrane. Given the small size of the perforations, no surgical repair was performed; instead, shorter implants were placed, and CGF membranes were applied. Postoperatively, both patients were prescribed a one-week course of metronidazole and amoxicillin, along with ephedrine-based decongestant nasal drops. At the 6-month follow-up CBCT evaluation, no signs of infection were observed, and the implants remained clinically stable without evidence of mucositis. No other intraoperative complications were noted in the remaining patients. In terms of postoperative complications, among patients who underwent bone chisel sinus floor elevation, three individuals experienced mild cephalic discomfort on the day of surgery, likely due to the relatively high density of the sinus floor cortical bone. In contrast, no such symptoms were observed in patients who received the modified surgical technique. From the third to the fifth day postoperatively, all patients exhibited mild gingival swelling and localized discomfort; however, no facial edema or ecchymosis was noted. No cases of postoperative maxillary sinusitis were recorded, and no significant symptoms of cephalic pressure or dizziness were reported. Overall, essential functions such as speech, mastication, and daily communication remained largely unaffected. The success rate and survival rate of the implants were both relatively high, with no statistically significant difference between the two. All implants had successfully undergone prosthetic installation, and no major complications were observed throughout the duration of the study. During the follow-up period for implant healing, no instances of implant loosening, peri-implant radiolucency, significant bone resorption, persistent numbness, or abnormal sensory changes were detected. Furthermore, no complications such as suppuration, bleeding, or soft tissue swelling were reported. Regarding the survival rate, one modified implant was lost four months after the completion of the prosthetic restoration. This resulted in a cumulative implant survival rate of 97.1%. The patient reported experiencing occlusal trauma from the opposing wisdom tooth prior to the loss of the implant. Discussion Maxillary sinus floor elevation (MSFE) can be performed using two primary approaches: the transcrestal approach and the lateral window approach. When the residual bone height (RBH) is ≥ 5 mm and the required elevation is < 5 mm, the transcrestal maxillary sinus floor elevation (TMSFE) is generally recommended. TMSFE offers several advantages, including procedural simplicity, minimal invasiveness, and reduced postoperative discomfort. Furthermore, the use of a bone chisel technique during implant site preparation contributes to initial implant stability. However, when the maxillary sinus floor is inclined, the risk of perforating the maxillary sinus mucosa significantly increases. In particular, for cases involving an inclined or septated sinus floor with uneven bone thickness, the thinner regions are more susceptible to accidental penetration into the sinus cavity during upward chiseling, while the thicker areas continue to resist, potentially causing sharp bony edges to puncture the sinus membrane. Additionally, the impact force generated by the bone chisel may result in greater patient discomfort due to head vibrations [ 10 , 11 ] . Therefore, for inclined maxillary sinus floors, the lateral window maxillary sinus floor elevation (LMSFE) is typically preferred. When the residual bone height is < 5 mm or when the sinus floor is inclined or septated, external sinus elevation performed under direct visualization is considered a more appropriate option. This approach offers enhanced safety, a greater elevation capacity, and more predictable outcomes. However, it requires the elevation of a larger soft tissue flap, which may lead to increased intraoperative bleeding, postoperative pain, and facial swelling. [ 12 , 13 ] As a technique-sensitive procedure, maintaining an adequate space between the root end of the implant and the surrounding area after MSFE is of critical importance. Bone substitute materials utilized in MSFE have been demonstrated to facilitate new bone formation postoperatively. These materials, placed between the sinus membrane and the implant root end as well as its surrounding region, undergo gradual resorption and remodeling over time [ 14 ] . In cases where the Schneiderian membrane is not adequately elevated or an insufficient quantity of bone substitute material is grafted during the procedure, there is an increased risk of implant exposure into the maxillary sinus cavity [ 15 ] . In the comparative experiment conducted by Cho Yong-Seok et al. on maxillary sinus floor elevation using PRF and normal saline, a measurable increase in bone volume was observed; however, the overall bone volume remained insufficient, and the risk of implant root exposure was relatively high [ 16 ] . In the study by H. Xue et al. on maxillary sinus floor elevation using a CAS-drill alone, a significant increase in bone volume was achieved, but the amount of bone retained at the sinus floor was relatively limited. When a smaller quantity of bone powder was used, the capacity to maintain the elevated sinus cavity space was compromised, leading to increased bone resorption during the later stages [ 17 ] . In the study by Alper Saglanmak et al., which employed a bone compaction drill for maxillary sinus floor elevation, the anticipated increase in bone volume was achieved; however, the height of the bone at the implant apex was uneven, thereby increasing the risk of localized implant root exposure postoperatively [ 18 ] . In the study by Jiayu Gao et al., which aimed to predict the risk of implant root tip exposure following maxillary sinus floor elevation using a nomogram, it was found that the residual maxillary height was not a limiting factor for simultaneous sinus elevation and implant placement. Rather, the determining factor was the initial stability of the implant [ 19 ] . In clinical practice, due to the limitations associated with blind surgical procedures, the actual amount of bone gain at the implant apex may be less than 2 mm [ 13 ] . However, as previously mentioned, root-end coverage of less than 2 mm increases the likelihood of implant apex exposure and the risk of associated maxillary sinus pathologies, which may ultimately lead to implant failure. Nevertheless, with regard to the influence of implant apex exposure and bone coverage thickness (either < 2 mm or ≥ 2 mm) on the effectiveness of maxillary sinus floor elevation, Jiayu Gao et al. reported in a follow-up study spanning 1 to 7 years that implant apex exposure or coverage of less than 2 mm did not significantly affect the short-term success or survival rates of the implants [ 20 ] . In this clinical scenario, we employ the minimally invasive alveolar crest approach, combining the use of a bone chisel with the SCA-KIT drill (modified technique), to elevate the maxillary sinus floor—a procedure of considerable clinical relevance, particularly for patients with a residual bone height of less than 5 mm. This approach not only facilitates the preservation of a greater volume of native sinus floor bone, but also minimizes patient discomfort in the cranial region and allows for the use of bone substitute materials to provide a buffering effect, ultimately achieving a favorable outcome in bone augmentation. During the surgical procedure, for a relatively flat maxillary sinus floor, the osteotome size can be selected based on the alveolar bone classification and the bone density of the maxillary sinus floor after gradually preparing the site to approximately 0.5–1 mm above the sinus floor. For types III and IV bone, an osteotome corresponding to the final prepared cavity size can be gently tapped to partially separate the sinus floor bone plate and mucosa from the surrounding structures. For types I and II bone, an initial small osteotome can be used to slightly elevate the maxillary sinus floor, followed by gradual cavity expansion using progressively larger osteotomes to achieve a greenstick fracture and further elevation. In cases where the maxillary sinus floor exhibits a slope, the procedure should begin with the smallest SCA preparation drill to reach the lowest point of the slope, followed by slight elevation using the smallest osteotome. Subsequently, cavity expansion can be performed using progressively larger SCA drills and osteotomes to achieve further elevation. Once the desired cavity shape is achieved, the largest applicable SCA drill can be used to prepare the site to the required depth and separate the surrounding mucosa. This approach is comparable to the staged sinus floor elevation technique [ 21 ] . Following this, a separator can be used to carefully detach the surrounding mucosa, and finally, bone graft particles can be incrementally added to expand the elevated area until the desired height is achieved. For cases involving alveolar bone with low bone density, the use of the chisel technique can effectively increase bone mass density, thereby improving implant stability [ 22 ] . In patients with a thin maxillary sinus membrane, a collagen sponge is employed during the procedure to gently separate the surrounding sinus membrane. Subsequently, a CGF membrane is placed within the sinus cavity to prevent maxillary sinus perforation, or alternatively, a gelatin sponge may be used as a protective cushion to minimize the risk of mucosal perforation during the sinus lift procedure. [ 23 , 24 , 25 , 26 ] Intraoperatively, it has been observed that the CGF membrane possesses the ability to aggregate Bio-oss bone powder particles, significantly reducing their dispersion into adjacent areas and thereby enhancing the overall quality of bone regeneration. The HaiAo biological membrane is primarily utilized for patients presenting with alveolar ridge deficiencies who require guided bone regeneration (GBR) surgery. Postoperative CBCT examination revealed that the side with a greater quantity of implanted bone powder particles following maxillary sinus floor mucosa elevation demonstrated superior bone formation, reduced bone resorption during the remodeling process around the implant, and increased bone coverage at the implant apex and surrounding areas. In contrast, the side with fewer implanted bone powder particles exhibited a relatively inferior bone formation outcome. These findings clearly highlight the importance of maintaining the created space for an extended period after maxillary sinus floor elevation, which allows sufficient time for effective bone remodeling [ 10 , 27 , 28 ] . The greater the extent of periosteal dissection around the maxillary sinus floor mucosa and the more bone powder particles implanted, the higher the achieved sinus floor elevation and the potential for increased bone remodeling height. This can be analogized to a pyramid: the larger the base, the greater the achievable height. Conversely, as the implanted bone powder is gradually resorbed, the bone coverage around and at the apex of the implant may be comparatively reduced. In patients with an inclined maxillary sinus floor, sinus membrane perforation is considered a risk factor when using the traditional bone chisel technique. Among the two cases of sinus membrane perforation observed during internal elevation using this technique in our study, one involved a patient with a significantly inclined sinus floor [ 29 , 30 ] . Claudio Stacchi et al. reported that in maxillary sinus floor elevation procedures with a residual bone height of ≤ 5 mm, wide maxillary sinuses are more susceptible to sinus membrane perforation compared to narrow ones [ 31 ] . The other case of sinus membrane perforation in our study involved a patient with a wide maxillary sinus floor and a thin sinus membrane. However, our findings indicated that an inclined maxillary sinus floor was associated with greater elevation height and increased bone augmentation. This may be attributed to the presence of one intact bony wall, which facilitates better dispersion of the bone grafting material, thereby significantly increasing the elevation height and range while reducing the risk of sinus membrane perforation. Consequently, postoperative CBCT scans confirmed that an inclined maxillary sinus floor was more conducive to achieving increased bone height. Furthermore, a concave sinus floor with a smaller angle in either the mesiodistal or buccolingual direction was found to be more favorable for bone augmentation compared to a flat sinus floor. Regarding the extent of periosteal dissection of the maxillary sinus floor mucosa, we quantified it by measuring the angle formed between the long axis of the implant and a straight line extending from the implant apex to the edge of the dissected periosteal area. A larger angle indicates a more extensive dissection range, which correlates with improved bone formation following remodeling. Intraoperative observations revealed that the angle of the dissection range on the buccolingual side was significantly greater than that on the mesiodistal side. This was primarily due to the fact that, in most patients, the angle of the maxillary sinus was naturally smaller on the buccolingual side compared to the mesiodistal side. To maximize the extent of periosteal dissection during surgery, we utilized the mucosal separator from the external elevation kit (DASK), which enabled us to dissect the periosteum around the maxillary sinus floor more effectively, thereby expanding the area of sinus elevation [ 32 , 33 , 34 ] . In cases of bone chisel maxillary sinus floor elevation without bone grafting, when the elevation height is within 2 mm, radiographic or histological evaluation reveals complete bone coverage at the apical and four lateral aspects of the implant. However, when the elevation height exceeds 2 mm, the degree of bone coverage at these regions gradually diminishes [ 11 , 30 ] . In contrast, for patients undergoing modified maxillary sinus floor elevation, significant bone regeneration can be observed at the apical and four surrounding regions of the implant both immediately post-surgery and 6–10 months after the procedure. Moreover, a notable increase in bone height within the posterior maxillary area is evident. Compared to the conventional bone chisel technique, the modified approach is associated with fewer postoperative complications, such as headache or dizziness. Nevertheless, the modified procedure is more time-consuming and requires greater surgical precision to elevate the sinus membrane safely and to place the bone grafting material effectively. The modified maxillary sinus floor elevation technique not only prevents perforation of the maxillary sinus, which may occur due to an inclined and thin sinus membrane, but also helps preserve a greater volume of maxillary sinus bone. This method provides more effective guidance for bone regeneration compared to simple elevation of the maxillary sinus mucosa. Particularly in patients with an alveolar bone height of less than 5 mm, this technique can achieve an ideal osteogenic outcome. During the procedure, the elevated maxillary sinus mucosa and the underlying bone surface can be clearly visualized. The surrounding mucosa can then be carefully dissected, allowing for the implantation of bone substitute materials under near-direct visualization. This ensures an optimal contact area between the sinus floor and the elevated bone, as well as the desired elevation height. Conclusions The modified maxillary sinus floor elevation technique is considered an optimal option for patients presenting with a wide maxillary sinus floor, thick buccal bone walls, limited mouth opening, and a low-lying, thick maxillary posterior artery. This technique not only facilitates the creation of sufficient bone volume to accommodate implant placement, but also significantly reduces the risk of sinus membrane perforation and alleviates postoperative discomfort. Nevertheless, long-term clinical follow-up is still required to further validate its efficacy and sustainability. Declarations Acknowledgments The authors gratefully acknowledge the participants in the ELSA survey. Authors’ Contributions Fengtong Liu, substantially contributed to conception or design, contributed to acquisition, analysis, or interpretation of data, drafted the manuscript, critically revised the manuscript for important intellectual content. Jun Cui, substantially contributed to design, contributed to acquisition, analysis, or interpretation of data, drafted the manuscript, critically revised the manuscript for important intellectual content. Fang Yuan and Yugang Sun, contributed to conception, contributed to acquisition or interpretation of data, critically revised the manuscript for important intellectual content. Tengfei Li, Wanggui Ying, Jianliang Shan, Xiaodong Sun, Fengli Li, Tingting Yu and Yanli Han, contributed to acquisition data, critically revised the manuscript for important intellectual content. All authors gave final approval and agree to be accountable for all aspects of the work in ensuring that questions relating to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by grants from the Science and Technology Development Program of Jinan Municipal Health Commission (Item Number: 2023-2-160). Special Fund for High level Talents in the Medical and Health Industry of Jinan , Shandong Province, PR.China.（grant number：202412）. Data availability The complete data and materials described in the research article are freely available from the corresponding author on reasonable request. Ethics approval and consent to participate Ethical approval was obtained from the ethical committee of the Jinan Stomatological Hospital (Approval number: JNSKQYY-2025-014). The study was in accordance with the Declaration of Helsinki. All participants provided written informed consent to participate in the study. Consent for publication Not applicable. Clinical trial number Not applicable. Competing interests The authors declare no competing interests. Author details 1.Department of Oral and Maxillofacial Surgery, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China. 2.Department of Prosthodontics, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China 3.Department of Prosthodontics, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China 4.Department of Endodontics and Prosthodontics, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China. 5.Oral Implant Center, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China. 6.Department of Medical Imaging, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China. References Davarpanah, M., Martinez, H., Tecucianu, J. F., Hage, G., & Lazzara, R. (2001). The modified osteotome technique. 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Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months. J Clin Med . 2024 Apr 11;13(8):2225. doi: 10.3390/jcm13082225. Jiayu Gao,Yufei Yang,Wumeng Yin,Xiangqi Zhao,Yili Qu,Xingmei Yang,Yingying Wu,Lin Xiang,Yi Man. A nomogram prediction of implant apical non-coverage on bone-added transcrestal sinus floor elevation: A retrospective cohort study. Clin Oral Implants Res . 2024 Mar;35(3):282-293. doi: 10.1111/clr.14225. Epub 2023 Dec 18. Gao J, Zhao X, Man Y, Qu Y. Effect of the implant apical exposure and coverage < or 2 mm bone graft on transcrestal sinus floor elevation: a 1- to 7-year retrospective cohort study. Clin Oral Investig. 2023 Jul;27(7):3611-3626. doi: 10.1007/s00784-023-04974-8. Epub 2023 Apr 3. Xianxian Zhuang,Jiating Lin,Hao Dong,Yin Wen,Ruoting Xian,Lu Cheng,Jingyi Wu,Shaobing Li. 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Luís Francisco,Manuel Francisco,Rosana Costa,Miguel Nunes Vasques,Marta Relvas,António Rajão,Luís Monteiro,Paulo Rompante,Fernando Guerra,Marco Infante da Câmara. Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone ® ) in Combination with Platelet-Rich Fibrin: A Case Series. Biomedicines . 2024 Jul 25;12(8):1661. doi: 10.3390/biomedicines12081661. J Huang,C Ban,L Liu,Y Ye. Dynamics and risk indicators of intrasinus elevation height following transalveolar sinus floor elevation with immediate implant placement: a longitudinal cohort study. Int J Oral Maxillofac Surg . 2021 Jan;50(1):109-115. doi: 10.1016/j.ijom.2020.04.020. Epub 2020 Jun 3. Yung-Ting Hsu,Paul S Rosen,Karishma Choksi,Ming-Chieh Shih,Shale Ninneman,Chun-Teh Lee. Complications of sinus floor elevation procedure and management strategies: A systematic review. Clin Implant Dent Relat Res . 2022 Dec;24(6):740-765. doi: 10.1111/cid.13086. Epub 2022 Jun 23. Xi Lin,Siqi Xu,Lijuan Chen,Guoying Que. Comparison of biomechanical characteristics of the Schneiderian membrane with different transcrestal sinus floor elevation techniques using three-dimensional finite element analysis. BMC Oral Health . 2025 Jan 28;25(1):146. doi: 10.1186/s12903-025-05499-0. Stacchi C, Bernardello F, Spinato S, Mura R, Perelli M, Lombardi T, Troiano G, Canullo L. Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height ≤5 mm: A retrospective multicenter study. Clin Oral Implants Res. 2022 Aug;33(8):783-791. doi: 10.1111/clr.13959. Epub 2022 May 29. Xiao She,Dongjiao Zhang,Xin Xu,Zhanwei Zhang,Chonghao Ji,Zechuan Li,Dawei Song. Influence of the contact area of the sub-antral space with sinus bone and the Schneiderian membrane on osteogenesis in lateral window sinus elevation surgery: a prospective experiment. BMC Oral Health . 2022 Dec 28;22(1):650. doi: 10.1186/s12903-022-02694-1. Saumya Prajapati,Shale Ninneman,Ida Zarrabi,Diane Daubert,I-Chung Wang,Yung-Ting Hsu. Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years. J Periodontol . 2023 Aug;94(8):1045-1054. doi: 10.1002/JPER.22-0424. Epub 2023 Feb 23. Shao Q, Li J, Pu R, Feng Y, Jiang Z, Yang G. Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study. Clin Implant Dent Relat Res. 2021 Dec;23(6):812-820. doi: 10.1111/cid.13052. Epub 2021 Nov 8. Tables Tables 1 to 3 are available in the Supplementary Files section Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Published Journal Publication published 19 Feb, 2026 Read the published version in BMC Oral Health → Version 1 posted Editorial decision: Revision requested 01 Dec, 2025 Reviews received at journal 27 Nov, 2025 Reviewers agreed at journal 27 Nov, 2025 Reviewers agreed at journal 11 Nov, 2025 Reviews received at journal 29 Oct, 2025 Reviewers agreed at journal 29 Oct, 2025 Reviews received at journal 13 Oct, 2025 Reviewers agreed at journal 10 Oct, 2025 Reviewers agreed at journal 09 Oct, 2025 Reviewers invited by journal 09 Oct, 2025 Editor invited by journal 01 Oct, 2025 Editor assigned by journal 29 Sep, 2025 Submission checks completed at journal 29 Sep, 2025 First submitted to journal 03 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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2","display":"","copyAsset":false,"role":"figure","size":59983,"visible":true,"origin":"","legend":"\u003cp\u003eElevation of the sinus floor mucosa utilizing a collagen sponge.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/475360ec20f6d0f6fd3eda56.png"},{"id":94205990,"identity":"3bdbb757-bd1f-47db-b288-34fa3e03b48e","added_by":"auto","created_at":"2025-10-23 14:40:25","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1677948,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart Illustrating the Modified Surgical Procedure.\u003c/p\u003e\n\u003cp\u003eA: Precision Positioning in Ball Drill Operations.\u003c/p\u003e\n\u003cp\u003eB: The small SCA drill is positioned at a distance of 0.5 mm from the sinus floor.\u003c/p\u003e\n\u003cp\u003eC: The bone chisel was carefully tapped to induce a greenstick fracture accompanied by a mild cortical bulge.\u003c/p\u003e\n\u003cp\u003eD: Gently elevate the sinus floor mucosa using a large SCA drill.\u003c/p\u003e\n\u003cp\u003eE: The DASK separator is utilized to separate the mucosal tissue at the base of the sinus.\u003c/p\u003e\n\u003cp\u003eF: The SCA bone powder filler is specifically designed for the purpose of filling bone defects with bone powder.\u003c/p\u003e\n\u003cp\u003eG: Install the implant.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/aa787f575e00bac3b1ee76d2.png"},{"id":94204522,"identity":"d90d1a75-7c80-4fad-a209-b9c5d98d6c1a","added_by":"auto","created_at":"2025-10-23 14:24:25","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":506032,"visible":true,"origin":"","legend":"\u003cp\u003ePreoperative and postoperative cone-beam computed tomography (CBCT) evaluations of modified maxillary sinus floor elevation are presented. Image A indicates that the extent of sinus floor mucosa detachment is adequate, but the quantity of implanted bone grafting material is insufficient. Image B shows that the range of mucosal stripping is inadequate, although the volume of grafted bone material is sufficient. Image C demonstrates that both the extent of mucosal elevation and the amount of bone graft material are sufficient. Time points: a, preoperative; b and c, immediate postoperative period; d and e, 6–10 months postoperatively; f and g, 2–3 months after prosthesis placement.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/0ba0a3b0b5a24265b077a5c5.png"},{"id":94204512,"identity":"c713c576-4ece-4179-a772-818a27365189","added_by":"auto","created_at":"2025-10-23 14:24:24","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":125496,"visible":true,"origin":"","legend":"\u003cp\u003eThe distance between the apical margin of the implant and the maxillary sinus floor following elevation: A represents measurements taken immediately postoperatively, and B represents measurements taken 6 to 10 months postoperatively. The bone coverage at the apical margin of the implant: C indicates immediate postoperative status, and D indicates status 6 to 10 months postoperatively. ****: P \u0026lt; 0.001, indicating a statistically significant difference.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/05664ee1fff34949091e4440.png"},{"id":94204541,"identity":"f12b09b2-9ad0-434c-a979-0a48ce19c92c","added_by":"auto","created_at":"2025-10-23 14:24:26","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":62610,"visible":true,"origin":"","legend":"\u003cp\u003eThe range and angle of maxillary sinus floor mucosa stripping are significantly greater on the buccal and palatal aspects compared to the mesial and distal aspects.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/939256563cbfac58515a1c66.png"},{"id":103251753,"identity":"1619dcfe-d78e-4179-9cd2-68e5232e0688","added_by":"auto","created_at":"2026-02-23 16:11:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4762275,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/3cdae3fb-c679-48f2-953d-99c77e461dd8.pdf"},{"id":94204517,"identity":"f908b518-908c-4a6a-b364-b63c38639033","added_by":"auto","created_at":"2025-10-23 14:24:25","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":25078,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-7527675/v1/8c2890b94ded282a2c9c8661.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Evaluation of Modified Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: A Retrospective Randomized Controlled Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eWith the continuous advancement of medical technology and an increasing patient focus on masticatory function and oral health, dental implant restoration has become a more commonly chosen option for individuals with missing teeth. Following the loss of posterior maxillary teeth, the absence of muscular attachment stimulation combined with the effects of negative pressure during respiration can lead to maxillary sinus pneumatization. This process results in a gradual thinning of the maxillary sinus bone wall and ultimately causes a reduction in the remaining bone height (RBH) in the posterior maxillary region. Furthermore, factors such as periodontitis, periapical inflammation, long-term alveolar ridge atrophy and resorption after tooth loss, as well as congenital underdevelopment of the posterior maxilla, can significantly compromise the available bone height. To address maxillary sinus pneumatization accompanied by alveolar bone resorption, maxillary sinus floor elevation has become a widely adopted clinical technique. Currently, two primary surgical approaches are employed in clinical practice: external maxillary sinus elevation and internal maxillary sinus elevation.\u003csup\u003e\u0026nbsp;[1,2]\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThere is no doubt that the external sinus lift procedure tends to cause greater trauma and impose a higher economic burden on patients\u003csup\u003e[3,4,5]\u003c/sup\u003e. Maxillary sinus floor elevation (MSFE) is a surgical technique that involves lifting the mucosa of the maxillary sinus floor via the alveolar ridge in order to create space for new bone formation. This procedure satisfies the minimum bone volume requirements necessary for implant placement, thereby expanding the indications for implant-supported restoration in the posterior maxillary region. In recent years, researchers have been actively investigating methods to effectively reduce operative time, minimize postoperative discomfort, and alleviate the financial burden on patients. With continuous advancements in clinical techniques, medical devices, and biomaterials, bone augmentation strategies associated with the internal sinus lift procedure are also continuously evolving. The aim is to preserve a greater amount of native bone at the maxillary sinus floor while achieving adequate space for successful bone grafting\u003csup\u003e[6,7,8]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eTo preserve a greater amount of bone at the maxillary sinus floor, ensure adequate space for bone graft materials and implant placement, and minimize postoperative discomfort, we assessed the short-term clinical efficacy and reliability of a modified combined technique involving the use of a bone chisel and SCA-KIT instruments for maxillary sinus floor elevation and simultaneous implant insertion in patients with insufficient vertical bone height in the posterior maxillary region, in comparison with the conventional bone chisel method.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis study on modified sinus floor elevation via the alveolar crest was conducted in strict accordance with the ethical principles outlined in the World Medical Association\u0026rsquo;s Declaration of Helsinki. It has been formally reviewed and approved by the Ethics Committee of Jinan Stomatological Hospital, Shandong Province, China (Approval No.: JNSKQYY-2025-014). All participants provided written informed consent after receiving a comprehensive explanation of the research objectives, procedures, and potential risks involved.\u003c/p\u003e\n\u003cp\u003eThis study enrolled a total of 64 patients (64 implants; 33 females and 31 males) who were scheduled to undergo maxillary sinus floor elevation via the alveolar crest approach between January 2023 and July 2025, with a follow-up duration ranging from 1 to 2 years. The mean age of the participants was 50 years, with an age range of 26 to 75 years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstruments and Materials:\u003c/strong\u003e Internal lifting tool SCA-KIT (South Korea), External lifting tool DASK-Dentium (South Korea), bone extruder (South Korea), bone substitute material\u0026mdash;Bio-Oss bone powder (produced by Geistlich Pharma AG, Switzerland), periosteal membrane\u0026mdash;HaiAo Oral Repair Membrane (manufactured by Yantai Zhenghai Bio-Technology Co., Ltd.), CGF (Concentrated Growth Factor), prepared from the patient\u0026apos;s autologous blood by a trained nurse using the DU LING JLC-I device)（Figure 1）, and Collagen Sponge (Beiling, produced by Beijing Yierkang Bio-Engineering Co., Ltd.).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDental implants\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eStraumann、OSSTEM and Astra\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria were as follows:\u003c/strong\u003e 1) presence of at least one missing maxillary posterior tooth; 2) residual bone height (RBH) in the maxillary posterior region of \u0026ge; 2 mm and \u0026lt; 10 mm; 3) completion of the final prosthesis installation; 4) maintenance of good oral hygiene and periodontal health, defined as no sites with bleeding on probing (BOP) and probing depths (PD) not exceeding 4 mm.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria included:\u003c/strong\u003e 1) systemic contraindications such as uncontrolled diabetes, hypertension, coagulation disorders, or other conditions affecting general health; 2) local contraindications such as uncontrolled periodontitis, maxillary sinusitis, maxillary osteomyelitis, or other local inflammatory conditions; 3) heavy smoking, defined as consumption of 10 or more cigarettes per day.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Procedure of Modified Internal Lifting Surgery\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patient should follow the instructions to rinse the mouth with compound chlorhexidine mouthwash for approximately three minutes prior to the procedure. The skin from the infraorbital region to the submandibular and neck areas should be disinfected using iodophor disinfectant solution, followed by the application of sterile dressings. At the commencement of the procedure, local anesthesia is administered via an injection of articaine hydrochloride and epinephrine (Novocol Pharmaceutical of Canada Inc.). Subsequently, an incision is made along the alveolar ridge, and full-thickness mucoperiosteal flaps on both the buccal and palatal sides are elevated to fully expose the implant site. Concurrently, blood samples are collected using a syringe.\u003c/p\u003e\n\u003cp\u003eFirst, a ball drill is used to determine the initial positioning. Subsequently, a preliminary probe drill equipped with a stop ring is employed to drill to a depth of approximately 0.5\u0026ndash;1 mm below the sinus floor. Next, the SCA drill is utilized to gradually prepare the cavity to a depth of approximately 0.5\u0026ndash;1 mm below the sinus floor. If the bone at the sinus floor is relatively dense, the cavity may be prepared to within 0.5 mm below the sinus floor. Once the implant site has reached the desired width, the sinus floor is gently tapped using a convex bone chisel to create a greenstick fracture and slight protrusion. Thereafter, the largest SCA drill is used to separate the protruding sinus floor bone from the surrounding sinus mucosa. A separator is then employed to carefully elevate the sinus mucosa around the cavity. Using a convex bone chisel that matches the shape of the cavity, the sinus membrane is lifted by approximately 1\u0026ndash;2 mm. This is followed by the use of various separators (DASK) to gradually separate the adjacent sinus membranes. Upon completion of the separation, a secondary elevation of the sinus membrane is performed to ensure sufficient height for implant placement. Finally, a depth gauge is used to assess the elevation of the sinus membrane, and the integrity of the sinus membrane is confirmed via the Valsalva maneuver. (Figure 3)\u003c/p\u003e\n\u003cp\u003eTo prevent rupture or perforation of the maxillary sinus mucosa during the elevation procedure, a stepwise mucosal separation technique was employed for cases with thinner sinus membrane. Specifically, the sheet-like collagen sponge was cut into continuous strips and placed progressively in all directions after initial separation of the sinus floor mucosa, thereby elevating the membrane to the desired height(Figure 2). Concurrently, CGF (Concentrated Growth Factor) membranes were prepared from autologous blood and placed at the sinus floor to minimize the risk of mucosal perforation. Additionally, a bone substitute material (Bio-Oss) was thoroughly mixed with autologous blood and carefully packed into the space beneath the elevated sinus membrane to ensure stable grafting.\u003c/p\u003e\n\u003cp\u003eFollowing the completion of the bone grafting procedure, an implant of standard length (\u0026ge;8 mm) is positioned within the recipient site. If adequate primary stability (torque \u0026ge; 25 N\u0026middot;cm) is attained, a healing abutment measuring 4 mm in height is affixed atop the implant. However, if the desired primary stability (torque \u0026lt; 25 N\u0026middot;cm) cannot be achieved or if a localized deficiency in the alveolar ridge necessitates additional bone grafting, the implant should be connected to a healing abutment with an increased diameter and a height of 2 mm. This ensures secure fixation of the implant within the cortical bone. Finally, the mucoperiosteal flap is sutured tightly to complete the procedure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePostoperative Management \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll patients underwent cone-beam computed tomography (CBCT) following surgery to confirm the precise position of the implant, the height of newly formed bone surrounding the implant, the mucosal elevation level, and the extent of flap mobilization. Starting on the day of surgery, all patients received a prophylactic anti-inflammatory regimen consisting of metronidazole and amoxicillin for a duration of 3 to 5 days. Sutures were removed on postoperative day 14. A healing period of 6 to 10 months was observed for all patients. Upon completion of the healing phase, CBCT imaging was performed again to evaluate the status of perimplant bone. In cases involving submerged implants, a second-stage surgical procedure was conducted.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePostoperative follow-ups were scheduled at 2 weeks, 1 month, 6\u0026ndash;10 months, and 1\u0026ndash;2 years after surgery. A systematic evaluation and documentation were performed regarding the condition of the peri-implant bone and soft tissues, in accordance with the consensus of the World Workshop on Periodontal and Peri-implant Diseases and Conditions, as well as the patients\u0026rsquo; subjective experiences. Based on CBCT imaging, the vertical bone height at the implant site was assessed. The specific measurement method was as follows: the distance from the alveolar crest to the lowest point of the maxillary sinus floor along the predetermined implant axis was defined as the remaining bone height; the distance from the alveolar crest to the elevated sinus membrane along the long axis of the implant was defined as the elevated bone height. The vertical bone increment was calculated as the difference between the remaining bone height and the elevated bone height (Figure 3G). Bone height measurements were performed twice using the same method\u0026mdash;immediately after surgery and at 6\u0026ndash;10 months postoperatively. Additionally, the bone height covering the apical end of the implant along its long axis was measured, including the distances from the bone planes at the mesial, distal, buccal, and palatal aspects of the implant to the apical reference plane. The extent of sinus membrane elevation was expressed as the angle formed between the line connecting the apical vertex of the implant and the edge point of the sinus membrane elevation and the long axis of the implant. All measurements were conducted three consecutive times by the same attending physician, and the median value was recorded for analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBaseline patient information. Mean \u0026plusmn; SD or n(%)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cimg 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\"\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical evaluation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThroughout the surgical procedure and the postoperative recovery phase, comprehensive documentation was maintained regarding intraoperative complications, including sinus membrane perforation and hemorrhage, as well as postoperative complications such as facial swelling, maxillary sinusitis, headache, and dizziness.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplant success and survival rates\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIn this study, the criteria for evaluating implant success include: (1) absence of clinical mobility of the implanted prostheses; (2) absence of radiographic evidence of peri-implant bone resorption on CBCT imaging; (3) absence of persistent pain, numbness, paresthesia, or other subjective symptoms reported by the patient; (4) absence of pathological conditions such as inflammation, bleeding, swelling, or suppuration in the peri-implant soft tissues; and (5) marginal bone loss (MBL) not exceeding 1.0 mm within the first year following implant loading\u003csup\u003e[9]\u003c/sup\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical methods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThis study employed inferential statistical methods using IBM SPSS Statistics 26.0 software to analyze the data. To assess the average increase in bone height immediately after surgery, the height of bone covering the root end margin of the implant (both immediately after surgery and 6\u0026ndash;10 months post-surgery), and the height of bone covering the axial root end of the implant (also measured at the two time points) between the two surgical techniques, the normal probability plot method was initially applied to determine whether the data followed a normal distribution. Subsequently, an F-test was conducted to evaluate the homogeneity of variances. Once the assumptions were satisfied, an independent samples t-test was performed for intergroup comparisons. The statistical analysis was conducted using a two-tailed test, with the significance level set at \u0026alpha; = 0.05. Additionally, linear regression analysis was utilized to examine the relationship between the measurement angle size and the extent of sinus floor mucosa elevation.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 64 patients were enrolled in this clinical study, each receiving one implant following trans-sinus floor elevation (TSFE). All participants underwent TSFE and implant placement simultaneously. Among these patients, 34 individuals, requiring a bone height increase of more than 3 mm, underwent the combined use of the bone chisel and sinus crestal approach (SCA), and received both implants and bone grafting material (Bio-Oss). The remaining 30 patients required a greater vertical augmentation (more than 5 mm); these individuals agreed only to undergo maxillary sinus floor elevation and declined the use of bone grafting materials. In this subgroup, maxillary sinus elevation was performed using the conventional bone chisel technique alone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe imaging examination results indicate that\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll surgical procedures were successfully completed. Patients who underwent modified maxillary sinus floor elevation achieved the desired bone augmentation outcomes. The mean residual bone height prior to surgery was 4.771 \u0026plusmn; 1.580 mm, with a mean increase in bone height of 6.016 \u0026plusmn; 1.312 mm postoperatively. For patients treated with the osteotome technique, the mean preoperative residual bone height was 7.856 \u0026plusmn; 1.367 mm, and the average postoperative increase in bone height was 2.797 \u0026plusmn; 0.898 mm.\u003c/p\u003e\n\u003cp\u003eThe axial bone height covering the apical portion of the implant was assessed immediately postoperatively and at 6\u0026ndash;10 months post-surgery. The mean values were 1.92 \u0026plusmn; 0.81 mm and 0.51 \u0026plusmn; 0.53 mm immediately postoperatively for the modified technique and the bone chisel method, respectively. At 6\u0026ndash;10 months post-surgery, the corresponding values were 1.39 \u0026plusmn; 0.67 mm for the modified method and 0.24 \u0026plusmn; 0.36 mm for the bone chisel method, with statistically significant differences between the two techniques.( Figure 5C.D,\u0026nbsp;Table 1)\u003c/p\u003e\n\u003cp\u003eThe bone height covering the apical margin of the implant was further analyzed at the same time points. Immediately postoperatively, measurements for the modified method were as follows: mesial 1.639 \u0026plusmn; 0.942 mm, distal 1.689 \u0026plusmn; 0.922 mm, buccal 1.625 \u0026plusmn; 0.959 mm, and palatal 1.807 \u0026plusmn; 0.718 mm. For the bone chisel method, the corresponding values were: mesial -0.296 \u0026plusmn; 1.148 mm, distal -0.254 \u0026plusmn; 1.046 mm, buccal -0.150 \u0026plusmn; 1.021 mm, and palatal 0.003 \u0026plusmn; 0.762 mm. At 6\u0026ndash;10 months post-surgery, the measurements for the modified method were: mesial 0.997 \u0026plusmn; 0.723 mm, distal 0.971 \u0026plusmn; 0.665 mm, buccal 0.979 \u0026plusmn; 0.801 mm, and palatal 1.062 \u0026plusmn; 0.591 mm. For the bone chisel method, the respective values were: mesial -0.697 \u0026plusmn; 1.140 mm, distal -0.650 \u0026plusmn; 1.113 mm, buccal -0.293 \u0026plusmn; 0.723 mm, and palatal -0.327 \u0026plusmn; 0.732 mm. All intergroup comparisons revealed statistically significant differences. ( Figure 5A.B,\u0026nbsp;Table 2.3)\u003c/p\u003e\n\u003cp\u003eAdditionally, the angle formed by the straight line connecting the apical vertex of the implant\u0026rsquo;s long axis and the mucosal separation point from the maxillary sinus floor, relative to the implant\u0026rsquo;s long axis, was measured immediately postoperatively. The mean angular values were: mesial 84.424 \u0026plusmn; 22.677\u0026deg;, distal 79.159 \u0026plusmn; 14.170\u0026deg;, buccal 94.635 \u0026plusmn; 18.402\u0026deg;, and palatal 91.812 \u0026plusmn; 15.198\u0026deg; for the modified technique. (Figure 6)\u003c/p\u003e\n\u003cp\u003eIn terms of intraoperative complications, two cases of sinus membrane perforation occurred in patients who underwent bone chisel elevation alone. Both perforations were less than 2mm in diameter. One case involved a more inclined maxillary sinus floor, while the other presented with a relatively flat and wide maxillary sinus floor accompanied by a thin sinus membrane. Given the small size of the perforations, no surgical repair was performed; instead, shorter implants were placed, and CGF membranes were applied. Postoperatively, both patients were prescribed a one-week course of metronidazole and amoxicillin, along with ephedrine-based decongestant nasal drops. At the 6-month follow-up CBCT evaluation, no signs of infection were observed, and the implants remained clinically stable without evidence of mucositis. No other intraoperative complications were noted in the remaining patients.\u003c/p\u003e\n\u003cp\u003eIn terms of postoperative complications, among patients who underwent bone chisel sinus floor elevation, three individuals experienced mild cephalic discomfort on the day of surgery, likely due to the relatively high density of the sinus floor cortical bone. In contrast, no such symptoms were observed in patients who received the modified surgical technique. From the third to the fifth day postoperatively, all patients exhibited mild gingival swelling and localized discomfort; however, no facial edema or ecchymosis was noted. No cases of postoperative maxillary sinusitis were recorded, and no significant symptoms of cephalic pressure or dizziness were reported. Overall, essential functions such as speech, mastication, and daily communication remained largely unaffected.\u003c/p\u003e\n\u003cp\u003eThe success rate and survival rate of the implants were both relatively high, with no statistically significant difference between the two. All implants had successfully undergone prosthetic installation, and no major complications were observed throughout the duration of the study. During the follow-up period for implant healing, no instances of implant loosening, peri-implant radiolucency, significant bone resorption, persistent numbness, or abnormal sensory changes were detected. Furthermore, no complications such as suppuration, bleeding, or soft tissue swelling were reported. Regarding the survival rate, one modified implant was lost four months after the completion of the prosthetic restoration. This resulted in a cumulative implant survival rate of 97.1%. The patient reported experiencing occlusal trauma from the opposing wisdom tooth prior to the loss of the implant.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eMaxillary sinus floor elevation (MSFE) can be performed using two primary approaches: the transcrestal approach and the lateral window approach. When the residual bone height (RBH) is \u0026ge;\u0026thinsp;5 mm and the required elevation is \u0026lt;\u0026thinsp;5 mm, the transcrestal maxillary sinus floor elevation (TMSFE) is generally recommended. TMSFE offers several advantages, including procedural simplicity, minimal invasiveness, and reduced postoperative discomfort. Furthermore, the use of a bone chisel technique during implant site preparation contributes to initial implant stability. However, when the maxillary sinus floor is inclined, the risk of perforating the maxillary sinus mucosa significantly increases. In particular, for cases involving an inclined or septated sinus floor with uneven bone thickness, the thinner regions are more susceptible to accidental penetration into the sinus cavity during upward chiseling, while the thicker areas continue to resist, potentially causing sharp bony edges to puncture the sinus membrane. Additionally, the impact force generated by the bone chisel may result in greater patient discomfort due to head vibrations\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. Therefore, for inclined maxillary sinus floors, the lateral window maxillary sinus floor elevation (LMSFE) is typically preferred. When the residual bone height is \u0026lt;\u0026thinsp;5 mm or when the sinus floor is inclined or septated, external sinus elevation performed under direct visualization is considered a more appropriate option. This approach offers enhanced safety, a greater elevation capacity, and more predictable outcomes. However, it requires the elevation of a larger soft tissue flap, which may lead to increased intraoperative bleeding, postoperative pain, and facial swelling. \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAs a technique-sensitive procedure, maintaining an adequate space between the root end of the implant and the surrounding area after MSFE is of critical importance. Bone substitute materials utilized in MSFE have been demonstrated to facilitate new bone formation postoperatively. These materials, placed between the sinus membrane and the implant root end as well as its surrounding region, undergo gradual resorption and remodeling over time \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. In cases where the Schneiderian membrane is not adequately elevated or an insufficient quantity of bone substitute material is grafted during the procedure, there is an increased risk of implant exposure into the maxillary sinus cavity \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn the comparative experiment conducted by Cho Yong-Seok et al. on maxillary sinus floor elevation using PRF and normal saline, a measurable increase in bone volume was observed; however, the overall bone volume remained insufficient, and the risk of implant root exposure was relatively high\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. In the study by H. Xue et al. on maxillary sinus floor elevation using a CAS-drill alone, a significant increase in bone volume was achieved, but the amount of bone retained at the sinus floor was relatively limited. When a smaller quantity of bone powder was used, the capacity to maintain the elevated sinus cavity space was compromised, leading to increased bone resorption during the later stages\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. In the study by Alper Saglanmak et al., which employed a bone compaction drill for maxillary sinus floor elevation, the anticipated increase in bone volume was achieved; however, the height of the bone at the implant apex was uneven, thereby increasing the risk of localized implant root exposure postoperatively\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. In the study by Jiayu Gao et al., which aimed to predict the risk of implant root tip exposure following maxillary sinus floor elevation using a nomogram, it was found that the residual maxillary height was not a limiting factor for simultaneous sinus elevation and implant placement. Rather, the determining factor was the initial stability of the implant\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn clinical practice, due to the limitations associated with blind surgical procedures, the actual amount of bone gain at the implant apex may be less than 2 mm \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. However, as previously mentioned, root-end coverage of less than 2 mm increases the likelihood of implant apex exposure and the risk of associated maxillary sinus pathologies, which may ultimately lead to implant failure. Nevertheless, with regard to the influence of implant apex exposure and bone coverage thickness (either \u0026lt;\u0026thinsp;2 mm or \u0026ge;\u0026thinsp;2 mm) on the effectiveness of maxillary sinus floor elevation, Jiayu Gao et al. reported in a follow-up study spanning 1 to 7 years that implant apex exposure or coverage of less than 2 mm did not significantly affect the short-term success or survival rates of the implants\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn this clinical scenario, we employ the minimally invasive alveolar crest approach, combining the use of a bone chisel with the SCA-KIT drill (modified technique), to elevate the maxillary sinus floor\u0026mdash;a procedure of considerable clinical relevance, particularly for patients with a residual bone height of less than 5 mm. This approach not only facilitates the preservation of a greater volume of native sinus floor bone, but also minimizes patient discomfort in the cranial region and allows for the use of bone substitute materials to provide a buffering effect, ultimately achieving a favorable outcome in bone augmentation.\u003c/p\u003e\u003cp\u003eDuring the surgical procedure, for a relatively flat maxillary sinus floor, the osteotome size can be selected based on the alveolar bone classification and the bone density of the maxillary sinus floor after gradually preparing the site to approximately 0.5\u0026ndash;1 mm above the sinus floor. For types III and IV bone, an osteotome corresponding to the final prepared cavity size can be gently tapped to partially separate the sinus floor bone plate and mucosa from the surrounding structures. For types I and II bone, an initial small osteotome can be used to slightly elevate the maxillary sinus floor, followed by gradual cavity expansion using progressively larger osteotomes to achieve a greenstick fracture and further elevation. In cases where the maxillary sinus floor exhibits a slope, the procedure should begin with the smallest SCA preparation drill to reach the lowest point of the slope, followed by slight elevation using the smallest osteotome. Subsequently, cavity expansion can be performed using progressively larger SCA drills and osteotomes to achieve further elevation. Once the desired cavity shape is achieved, the largest applicable SCA drill can be used to prepare the site to the required depth and separate the surrounding mucosa. This approach is comparable to the staged sinus floor elevation technique\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. Following this, a separator can be used to carefully detach the surrounding mucosa, and finally, bone graft particles can be incrementally added to expand the elevated area until the desired height is achieved.\u003c/p\u003e\u003cp\u003eFor cases involving alveolar bone with low bone density, the use of the chisel technique can effectively increase bone mass density, thereby improving implant stability\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. In patients with a thin maxillary sinus membrane, a collagen sponge is employed during the procedure to gently separate the surrounding sinus membrane. Subsequently, a CGF membrane is placed within the sinus cavity to prevent maxillary sinus perforation, or alternatively, a gelatin sponge may be used as a protective cushion to minimize the risk of mucosal perforation during the sinus lift procedure. \u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e Intraoperatively, it has been observed that the CGF membrane possesses the ability to aggregate Bio-oss bone powder particles, significantly reducing their dispersion into adjacent areas and thereby enhancing the overall quality of bone regeneration. The HaiAo biological membrane is primarily utilized for patients presenting with alveolar ridge deficiencies who require guided bone regeneration (GBR) surgery.\u003c/p\u003e\u003cp\u003ePostoperative CBCT examination revealed that the side with a greater quantity of implanted bone powder particles following maxillary sinus floor mucosa elevation demonstrated superior bone formation, reduced bone resorption during the remodeling process around the implant, and increased bone coverage at the implant apex and surrounding areas. In contrast, the side with fewer implanted bone powder particles exhibited a relatively inferior bone formation outcome. These findings clearly highlight the importance of maintaining the created space for an extended period after maxillary sinus floor elevation, which allows sufficient time for effective bone remodeling\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. The greater the extent of periosteal dissection around the maxillary sinus floor mucosa and the more bone powder particles implanted, the higher the achieved sinus floor elevation and the potential for increased bone remodeling height. This can be analogized to a pyramid: the larger the base, the greater the achievable height. Conversely, as the implanted bone powder is gradually resorbed, the bone coverage around and at the apex of the implant may be comparatively reduced.\u003c/p\u003e\u003cp\u003eIn patients with an inclined maxillary sinus floor, sinus membrane perforation is considered a risk factor when using the traditional bone chisel technique. Among the two cases of sinus membrane perforation observed during internal elevation using this technique in our study, one involved a patient with a significantly inclined sinus floor\u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e. Claudio Stacchi et al. reported that in maxillary sinus floor elevation procedures with a residual bone height of \u0026le;\u0026thinsp;5 mm, wide maxillary sinuses are more susceptible to sinus membrane perforation compared to narrow ones \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. The other case of sinus membrane perforation in our study involved a patient with a wide maxillary sinus floor and a thin sinus membrane. However, our findings indicated that an inclined maxillary sinus floor was associated with greater elevation height and increased bone augmentation. This may be attributed to the presence of one intact bony wall, which facilitates better dispersion of the bone grafting material, thereby significantly increasing the elevation height and range while reducing the risk of sinus membrane perforation. Consequently, postoperative CBCT scans confirmed that an inclined maxillary sinus floor was more conducive to achieving increased bone height. Furthermore, a concave sinus floor with a smaller angle in either the mesiodistal or buccolingual direction was found to be more favorable for bone augmentation compared to a flat sinus floor.\u003c/p\u003e\u003cp\u003eRegarding the extent of periosteal dissection of the maxillary sinus floor mucosa, we quantified it by measuring the angle formed between the long axis of the implant and a straight line extending from the implant apex to the edge of the dissected periosteal area. A larger angle indicates a more extensive dissection range, which correlates with improved bone formation following remodeling. Intraoperative observations revealed that the angle of the dissection range on the buccolingual side was significantly greater than that on the mesiodistal side. This was primarily due to the fact that, in most patients, the angle of the maxillary sinus was naturally smaller on the buccolingual side compared to the mesiodistal side. To maximize the extent of periosteal dissection during surgery, we utilized the mucosal separator from the external elevation kit (DASK), which enabled us to dissect the periosteum around the maxillary sinus floor more effectively, thereby expanding the area of sinus elevation\u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn cases of bone chisel maxillary sinus floor elevation without bone grafting, when the elevation height is within 2 mm, radiographic or histological evaluation reveals complete bone coverage at the apical and four lateral aspects of the implant. However, when the elevation height exceeds 2 mm, the degree of bone coverage at these regions gradually diminishes\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e. In contrast, for patients undergoing modified maxillary sinus floor elevation, significant bone regeneration can be observed at the apical and four surrounding regions of the implant both immediately post-surgery and 6\u0026ndash;10 months after the procedure. Moreover, a notable increase in bone height within the posterior maxillary area is evident. Compared to the conventional bone chisel technique, the modified approach is associated with fewer postoperative complications, such as headache or dizziness. Nevertheless, the modified procedure is more time-consuming and requires greater surgical precision to elevate the sinus membrane safely and to place the bone grafting material effectively.\u003c/p\u003e\u003cp\u003eThe modified maxillary sinus floor elevation technique not only prevents perforation of the maxillary sinus, which may occur due to an inclined and thin sinus membrane, but also helps preserve a greater volume of maxillary sinus bone. This method provides more effective guidance for bone regeneration compared to simple elevation of the maxillary sinus mucosa. Particularly in patients with an alveolar bone height of less than 5 mm, this technique can achieve an ideal osteogenic outcome. During the procedure, the elevated maxillary sinus mucosa and the underlying bone surface can be clearly visualized. The surrounding mucosa can then be carefully dissected, allowing for the implantation of bone substitute materials under near-direct visualization. This ensures an optimal contact area between the sinus floor and the elevated bone, as well as the desired elevation height.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe modified maxillary sinus floor elevation technique is considered an optimal option for patients presenting with a wide maxillary sinus floor, thick buccal bone walls, limited mouth opening, and a low-lying, thick maxillary posterior artery. This technique not only facilitates the creation of sufficient bone volume to accommodate implant placement, but also significantly reduces the risk of sinus membrane perforation and alleviates postoperative discomfort. Nevertheless, long-term clinical follow-up is still required to further validate its efficacy and sustainability.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors gratefully acknowledge the participants in the ELSA survey.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFengtong Liu, substantially contributed to conception or design, contributed to acquisition, analysis, or interpretation of data, drafted the manuscript, critically revised the manuscript for important intellectual content. Jun Cui, substantially contributed to design, contributed to acquisition, analysis, or interpretation of data, drafted the manuscript, critically revised the manuscript for important intellectual content. Fang Yuan and Yugang Sun, contributed to conception, contributed to acquisition or interpretation of data, critically revised the manuscript for important intellectual content. Tengfei Li, Wanggui Ying, Jianliang Shan, Xiaodong Sun, Fengli Li, Tingting Yu and Yanli Han, contributed to acquisition data, critically revised the manuscript for important intellectual content. All authors gave final approval and agree to be accountable for all aspects of the work in ensuring that questions relating to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by grants from the Science and Technology Development Program of Jinan Municipal Health Commission (Item Number: 2023-2-160). Special Fund for High level Talents in the Medical and Health Industry of Jinan , Shandong Province, PR.China.（grant number：202412）.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe complete data and materials described in the research article are freely available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the ethical committee of the Jinan Stomatological Hospital (Approval number: JNSKQYY-2025-014). The study was in accordance with the Declaration of Helsinki. All participants provided written informed consent to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1.Department of Oral and Maxillofacial Surgery, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China.\u003c/p\u003e\n\u003cp\u003e2.Department of Prosthodontics, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China\u003c/p\u003e\n\u003cp\u003e3.Department of Prosthodontics, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China\u003c/p\u003e\n\u003cp\u003e4.Department of Endodontics and Prosthodontics, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China.\u003c/p\u003e\n\u003cp\u003e5.Oral Implant Center, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China.\u003c/p\u003e\n\u003cp\u003e6.Department of Medical Imaging, Shungeng Campus, Jinan Stomatological Hospital, Shizhong District, Jinan City, Shandong Province, China.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDavarpanah, M., Martinez, H., Tecucianu, J. 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Epub 2021 Feb 17.\u003c/li\u003e\n\u003cli\u003eYuki Omori,Yasushi Nakajima,Hideki Imai,Daichi Yonezawa,Mauro Ferri,Karol Al\u0026iacute; Apaza Alccayhuaman,Daniele Botticelli. Influence of Anatomical Parameters on the Dimensions of the Subantral Space and Sinus Mucosa Thickening after Sinus Floor Elevation. A Retrospective Cone Beam Computed Tomography Study. Dent J (Basel) . 2021 Jun 24;9(7):76. doi: 10.3390/dj9070076.\u003c/li\u003e\n\u003cli\u003eShigeru Sakuma,Mauro Ferri,Hideki Imai,Natalia Fortich Mesa,Daniel Jos\u0026eacute; Blanco Victorio,Karol Al\u0026iacute; Apaza Alccayhuaman,Daniele Botticelli. Involvement of the maxillary sinus ostium (MSO) in the edematous processes after sinus floor augmentation: a cone-beam computed tomographic study. Int J Implant Dent . 2020 Sep 30;6(1):35. doi: 10.1186/s40729-020-00233-7.\u003c/li\u003e\n\u003cli\u003eHuixin Lv,Xiaolin Sun,Jia Wang,Hanchi Wang,Lin Wang,Yanmin Zhou. Flapless osteotome-mediated sinus floor elevation using platelet-rich fibrin versus lateral approach using deproteinised bovine bone mineral for residual bone height of 2-6 mm: A randomised trial. Clin Oral Implants Res . 2022 Jul;33(7):700-712. doi: 10.1111/clr.13934. Epub 2022 May 7.\u003c/li\u003e\n\u003cli\u003eMajd Mohrez,Mohey A Amam,Amirah Alnour,Ealaf Abdoh,Alaa Alnajjar,Zavin K Beit. Immediate dental implantation after indirect sinus elevation using osseodensification concept: a case report. Ann Med Surg (Lond) . 2023 Jun 5;85(8):4060-4066. doi: 10.1097/MS9.0000000000000907. eCollection 2023 Aug.\u003c/li\u003e\n\u003cli\u003eMauricio Marcelo Harlos,Thiago Bezerra da Silva,Pedro Giorgetti Montagner,Lucas Novaes Teixeira,Adriana Vanderley Gomes,Elizabeth Ferreira Martinez. Histomorphometric evaluation of different graft associations for maxillary sinus elevation in wide antral cavities: a randomized controlled clinical trial. Clin Oral Investig . 2022 Aug;26(8):1-9. doi: 10.1007/s00784-022-04515-9. Epub 2022 May 5.\u003c/li\u003e\n\u003cli\u003eJepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, Demirel K, de Sanctis M, Ercoli C, Fan J, Geurs NC, Hughes FJ, Jin L, Kantarci A, Lalla E, Madianos PN, Matthews D, McGuire MK, Mills MP, Preshaw PM, Reynolds MA, Sculean A, Susin C。Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018 Jun;45 Suppl 20:S219-S229. doi: 10.1111/jcpe.12951.\u003c/li\u003e\n\u003cli\u003eYuting Zhang,Xin Zhang,Jian Wang,Qianbing Wan,Lei Li. A Modified Transalveolar Sinus Floor Elevation Approach With a Bilaterally Enlarged Osteotomy. J Oral Implantol . 2022 Jun 1;48(3):237-242. doi: 10.1563/aaid-joi-D-20-00173.\u003c/li\u003e\n\u003cli\u003ePjetursson BE, Lang NP. 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Clin Oral Implants Res 31:105\u0026ndash;120. https:// doi. org/ 10. 1111/ clr. 13541 \u003c/li\u003e\n\u003cli\u003eUeno D, Banba N, Hasuike A, Ueda K, Kodama T (2019) A sinus foor reaugmentation technique around an apically exposed implant into the maxillary sinus. J Oral Implantol 45:213\u0026ndash;217. https:// doi. org/ 10. 1563/ aaid- joi-D- 18- 00271\u003c/li\u003e\n\u003cli\u003eNedir R, Nurdin N, Abi Najm S, El Hage M, Bischof M (2017) Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study. Clin Oral Implants Res 28:877\u0026ndash;886. https:// doi. org/ 10. 1111/ clr. 12893\u003c/li\u003e\n\u003cli\u003ePRF.Yong-Seok Cho,Kyung-Gyun Hwang,Sang Ho Jun,Marco Tallarico,Amy M Kwon,Chang-Joo Park. Radiologic comparative analysis between saline and platelet-rich fibrin filling after hydraulic transcrestal sinus lifting without adjunctive bone graft: A randomized controlled trial. Clin Oral Implants Res . 2020 Nov;31(11):1087-1093. doi: 10.1111/clr.13655. Epub 2020 Sep 18.\u003c/li\u003e\n\u003cli\u003eH Xue,J Wen,C Liu,X Shuai,X Zhang,N Kang. Modified transcrestal sinus floor elevation with concomitant implant placement in edentulous posterior maxillae with residual bone height of 5 mm or less: a non-controlled prospective study. Int J Oral Maxillofac Surg . 2023 Apr;52(4):495-502. doi: 10.1016/j.ijom.2022.08.014. Epub 2022 Sep 2.\u003c/li\u003e\n\u003cli\u003eAlper Saglanmak,Ihsan Caglar Cinar,Mohammed Zboun,Volkan Arisan,Eitan Mijiritsky. Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months. J Clin Med . 2024 Apr 11;13(8):2225. doi: 10.3390/jcm13082225.\u003c/li\u003e\n\u003cli\u003eJiayu Gao,Yufei Yang,Wumeng Yin,Xiangqi Zhao,Yili Qu,Xingmei Yang,Yingying Wu,Lin Xiang,Yi Man. A nomogram prediction of implant apical non-coverage on bone-added transcrestal sinus floor elevation: A retrospective cohort study. Clin Oral Implants Res . 2024 Mar;35(3):282-293. doi: 10.1111/clr.14225. Epub 2023 Dec 18.\u003c/li\u003e\n\u003cli\u003eGao J, Zhao X, Man Y, Qu Y. Effect of the implant apical exposure and coverage \u0026lt; or 2 mm bone graft on transcrestal sinus floor elevation: a 1- to 7-year retrospective cohort study. Clin Oral Investig. 2023 Jul;27(7):3611-3626. doi: 10.1007/s00784-023-04974-8. Epub 2023 Apr 3.\u003c/li\u003e\n\u003cli\u003eXianxian Zhuang,Jiating Lin,Hao Dong,Yin Wen,Ruoting Xian,Lu Cheng,Jingyi Wu,Shaobing Li. The transalveolar approach with the small segmentation method for inclined maxillary sinus floor elevation: A retrospective study. Clin Implant Dent Relat Res . 2024 Feb;26(1):216-225. doi: 10.1111/cid.13281. Epub 2023 Sep 26.\u003c/li\u003e\n\u003cli\u003eJun-Yu Shi,Shu-Jiao Qian,Ying-Xin Gu,Shi-Chong Qiao,Maurizio S Tonetti,Hong-Chang Lai. Long-term outcomes of osteotome sinus floor elevation without grafting in severely atrophic maxilla: A 10-year prospective study. J Clin Periodontol . 2020 Dec;47(12):1528-1535. doi: 10.1111/jcpe.13365. Epub 2020 Oct 2.\u003c/li\u003e\n\u003cli\u003eJiayu Gao,Wumeng Yin,Yeyu Liu,Xiangqi Zhao,Yili Qu,Yi Man. Effectiveness and complications of transcrestal sinus floor elevation using the cushioned grind-out technique: A retrospective cohort study with up to 7 years of follow-up. J Clin Periodontol . 2023 Sep;50(9):1202-1216. doi: 10.1111/jcpe.13832. Epub 2023 Jun 4.\u003c/li\u003e\n\u003cli\u003eChen Deng,Chenyi Xiong,Yi Man,Yili Qu. Combination of a surgical template and a collagen strip for guiding sinus floor elevation in the oblique sinus floor: A technical note. J Stomatol Oral Maxillofac Surg . 2023 Dec;124(6):101495. doi: 10.1016/j.jormas.2023.101495. Epub 2023 May 9.\u003c/li\u003e\n\u003cli\u003eFatma Kandel,Mohamed Shawky,Amr Gibaly,Mohamed Mounir,Niveen Askar,Mohammed Atef. Assessment of absorbable gelatin sponge for maxillary sinus floor elevation versus anorganic bovine bone minerals: a randomized clinical trial. Oral Maxillofac Surg . 2023 Sep;27(3):469-478. doi: 10.1007/s10006-022-01086-7. Epub 2022 Jun 13.\u003c/li\u003e\n\u003cli\u003eJiayu Gao,Wumeng Yin,Yeyu Liu,Xiangqi Zhao,Vicha Huangphattarakul,Yili Qu,Yi Man. Cushioned grind-out technique transcrestal sinus floor elevation for simultaneous implantation in severe atrophic maxilla: A retrospective study with up to 7 years of follow-up. Clin Oral Implants Res . 2023 Jul;34(7):727-740. doi: 10.1111/clr.14099. Epub 2023 May 25.\u003c/li\u003e\n\u003cli\u003eLu\u0026iacute;s Francisco,Manuel Francisco,Rosana Costa,Miguel Nunes Vasques,Marta Relvas,Ant\u0026oacute;nio Raj\u0026atilde;o,Lu\u0026iacute;s Monteiro,Paulo Rompante,Fernando Guerra,Marco Infante da C\u0026acirc;mara. Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone\u003csup\u003e\u0026reg;\u003c/sup\u003e) in Combination with Platelet-Rich Fibrin: A Case Series. Biomedicines . 2024 Jul 25;12(8):1661. doi: 10.3390/biomedicines12081661.\u003c/li\u003e\n\u003cli\u003eJ Huang,C Ban,L Liu,Y Ye. Dynamics and risk indicators of intrasinus elevation height following transalveolar sinus floor elevation with immediate implant placement: a longitudinal cohort study. Int J Oral Maxillofac Surg . 2021 Jan;50(1):109-115. doi: 10.1016/j.ijom.2020.04.020. Epub 2020 Jun 3.\u003c/li\u003e\n\u003cli\u003eYung-Ting Hsu,Paul S Rosen,Karishma Choksi,Ming-Chieh Shih,Shale Ninneman,Chun-Teh Lee. Complications of sinus floor elevation procedure and management strategies: A systematic review. Clin Implant Dent Relat Res . 2022 Dec;24(6):740-765. doi: 10.1111/cid.13086. Epub 2022 Jun 23.\u003c/li\u003e\n\u003cli\u003eXi Lin,Siqi Xu,Lijuan Chen,Guoying Que. Comparison of biomechanical characteristics of the Schneiderian membrane with different transcrestal sinus floor elevation techniques using three-dimensional finite element analysis. BMC Oral Health . 2025 Jan 28;25(1):146. doi: 10.1186/s12903-025-05499-0.\u003c/li\u003e\n\u003cli\u003eStacchi C, Bernardello F, Spinato S, Mura R, Perelli M, Lombardi T, Troiano G, Canullo L. Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height\u0026thinsp;\u0026le;5\u0026thinsp;mm: A retrospective multicenter study. Clin Oral Implants Res. 2022 Aug;33(8):783-791. doi: 10.1111/clr.13959. Epub 2022 May 29.\u003c/li\u003e\n\u003cli\u003eXiao She,Dongjiao Zhang,Xin Xu,Zhanwei Zhang,Chonghao Ji,Zechuan Li,Dawei Song. Influence of the contact area of the sub-antral space with sinus bone and the Schneiderian membrane on osteogenesis in lateral window sinus elevation surgery: a prospective experiment. BMC Oral Health . 2022 Dec 28;22(1):650. doi: 10.1186/s12903-022-02694-1.\u003c/li\u003e\n\u003cli\u003eSaumya Prajapati,Shale Ninneman,Ida Zarrabi,Diane Daubert,I-Chung Wang,Yung-Ting Hsu. Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years. J Periodontol . 2023 Aug;94(8):1045-1054. doi: 10.1002/JPER.22-0424. Epub 2023 Feb 23.\u003c/li\u003e\n\u003cli\u003eShao Q, Li J, Pu R, Feng Y, Jiang Z, Yang G. Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study. Clin Implant Dent Relat Res. 2021 Dec;23(6):812-820. doi: 10.1111/cid.13052. Epub 2021 Nov 8.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Maxillary Sinus Floor Elevation, Bone Augmentation, Dental Implants, Bone Substitute Materials, Residual Bone Height","lastPublishedDoi":"10.21203/rs.3.rs-7527675/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7527675/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aimed to evaluate the clinical efficacy and reliability of an improved maxillary sinus floor elevation technique when applied to cases with severe bone deficiency in the posterior maxillary region, with simultaneous implant placement.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA total of 64 edentulous patients with maxillary bone deficiencies were enrolled in this study. Of these, 34 underwent the improved maxillary sinus floor elevation technique combined with immediate implant placement, while the remaining 30 received the conventional bone chisel technique also followed by simultaneous implant placement. Radiological and clinical assessments were performed to comprehensively evaluate the practical applicability of the improved technique and compare its osteogenic outcomes with those of the conventional method.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe mean increase in maxillary bone height was 6.016\u0026thinsp;\u0026plusmn;\u0026thinsp;1.312 mm in the improved technique group and 2.797\u0026thinsp;\u0026plusmn;\u0026thinsp;0.898 mm in the conventional bone chisel group, with a statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The bone coverage at the apical portion of the implant was significantly greater in the improved technique group both immediately post-surgery and 6\u0026ndash;10 months after the procedure (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Similarly, the perimplant bone condition in the improved technique group showed statistically significant improvement compared to the conventional technique at both time points (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No significant differences were observed in short-term implant survival and success rates between the two groups. Notably, no complications such as maxillary sinus membrane perforation or postoperative symptoms including headache, dizziness, or discomfort were reported in the improved technique group.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe improved maxillary sinus floor elevation technique demonstrates favorable clinical outcomes for patients with insufficient posterior maxillary bone height, particularly in cases where the residual height is less than 5 mm. Although no significant differences were found in short-term implant success and survival rates, the improved technique offers enhanced bone augmentation and reduced complication risks.\u003c/p\u003e","manuscriptTitle":"Clinical Evaluation of Modified Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: A Retrospective Randomized Controlled Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-23 14:24:19","doi":"10.21203/rs.3.rs-7527675/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-01T08:07:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-28T04:45:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"87922295466167733701133606591244262667","date":"2025-11-28T01:42:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"340255824831412533757304101658888406167","date":"2025-11-12T03:09:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-29T15:56:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98678680178649583201217542770131504600","date":"2025-10-29T15:41:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-13T05:10:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"259449022009656373602908193634184311242","date":"2025-10-10T05:40:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"168290101156623406325831289634438938920","date":"2025-10-09T14:38:31+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-09T14:25:51+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-01T12:26:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-29T08:59:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-29T08:56:06+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-09-03T13:39:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c559fca2-1400-4ed0-9826-a4ab3cba600f","owner":[],"postedDate":"October 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-23T16:08:41+00:00","versionOfRecord":{"articleIdentity":"rs-7527675","link":"https://doi.org/10.1186/s12903-026-07951-1","journal":{"identity":"bmc-oral-health","isVorOnly":false,"title":"BMC Oral Health"},"publishedOn":"2026-02-19 15:57:15","publishedOnDateReadable":"February 19th, 2026"},"versionCreatedAt":"2025-10-23 14:24:19","video":"","vorDoi":"10.1186/s12903-026-07951-1","vorDoiUrl":"https://doi.org/10.1186/s12903-026-07951-1","workflowStages":[]},"version":"v1","identity":"rs-7527675","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7527675","identity":"rs-7527675","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}