Novel use of dynamic navigation for guiding a piezoelectric device during window osteotomy for maxillary sinus floor elevation in complex clinical scenarios.

In patients with severe atrophy of the posterior maxilla requiring lateral maxillary sinus floor elevation (MSFE), the window location and size are commonly designed according to the future implants and anatomical conditions. A window osteotomy becomes challenging when there is an extended edentulous space in the maxilla with no reference from the natural dentition, or when the surgical site involves anatomical variations, for example in the course of a large vessel or a sinus septum. Through preoperative planning and real-time visualization, the application of dynamic navigation allows an accurate location, optimal dimension, and customized shape during lateral window osteotomy. This article introduces a digital protocol for ensuring an accurate and safe window osteotomy for MSFE in complex clinical scenarios, by integrating dynamic navigation and a piezoelectric device.