Sinus Floor Elevation From Palatal Approach With Simultaneous Implant Placement: A Case Report.

INTRODUCTION: In traditional maxillary sinus lift elevation with simultaneous implant placement with deficient residual bone in the posterior region of the maxilla, lateral window osteotomy is commonly employed. However, due to specific anatomical variations, such as an excessively thick buccal bone wall, a palatal approach with simultaneous implant placement may serve as a preferable alternative in selected cases.

CASE PRESENTATION: A 48-year-old male requested implant-supported restoration in the left maxillary posterior region. Preoperative cone-beam computed tomography (CBCT) revealed insufficient vertical bone height with a residual bone height (RBH) of 2-3 mm. Given that the lateral wall of the maxillary sinus was significantly thicker than the palatal wall, whereas the alveolar ridge width was sufficient, a palatal approach was executed using the DASK kit for sinus osteotomy, accompanied by simultaneous implant placement. Postoperative CBCT confirmed a sinus graft height of 10 mm, with the bone graft material thoroughly surrounding the implants. Postoperative swelling was minimal. At the 7-month postoperative follow-up, CBCT demonstrated a continuous bone-to-implant interface without peri-implant radiolucency, alongside a homogeneous radiopaque appearance of the grafted sinus blending with the native bone, confirming mature osteogenesis and permitting final prosthesis delivery.

CONCLUSIONS: The palatal approach for maxillary sinus floor elevation with simultaneous implant placement is a technically feasible treatment modality under specific anatomical conditions.