HANSAmed Geistlich Sinus floor elevation

Sinus Floor Elevation

Following the loss of a premolar or molar, posterior maxilla bone height is often insufficient for implant placement. A sinus floor elevation procedure creates additional bone height, either via a transcrestal or lateral window approach.

Sinus augmentation procedures can be conducted before implant placement (two-stage surgery) or simultaneously (single surgery). The posterior maxilla residual bone and sinus anatomy must be analyzed prior to planning the procedure and determining the timing of implant placement. The following table shows a simplified summary of the current guidelines.1-5

Residual bone height > 10 mm (class A)

  • Classical implant procedure 

Residual bone height 7-9 mm (class B)

  • Osteotome technique 
  • Immediate implant placement

Residual bone height 4-6 mm (class C)

  • Lateral antrostomy 
  • Bone replacement material
  • Immediate or delayed implant placement

Residual bone height 1-3 mm (class D)

  • Lateral antrostomy 
  • Bone replacement material 
  • Delayed implant placement

Sinus floor elevation procedures utilizing bone graft materials to augment the bone in the posterior maxilla can be performed before or simultaneously with implant placement. 

Lateral approach for a sinus lift elevation procedure.
Crestal approach for a sinus lift elevation procedure.

The high reliability of Geistlich biomaterials for these indications has been shown in more than 200 sinus augmentation studies.6 Evidence indicates that xenogeneous materials result in superior long-term results in sinus floor elevation compared to autogenous bone chips.7

Application of a membrane such as Geistlich Bio-Gide® increases implant survival rate significantly.8 Geistlich Bio-Gide® can also be placed in the sinus to protect a perforated Schneiderian membrane during the surgical procedure and subsequent post-operative healing.

More than 200 sinus augmentation studies document predictable outcomes achieved with Geistlich products.6

Predictability of the implant survival rates in external sinus floor elevation (5128 implants, follow-up 12–102 months).7 Note: the 22 referenced studies with xenogeneic materials were conducted with Geistlich Bio-Oss®. By using a membrane for sinus floor elevation, the implant survival rate is significantly increased by 9.3% (meta-analysis in humans).8
Inserting the protective Geistlich Bio-Gide® membrane into the sinus.
Insertion of the Geistlich Bio-Oss® granules with Geistlich Bio-Oss Pen®.
Coverage of the graft material with a protective Geistlich Bio-Gide® membrane.
  1. Summers RB Compendium. 1994; 15(2):152, 154-6, 158 passim; quiz 162.
  2. Zitzmann NU: Int J Oral Maxillofac Implants 1997; 12(6): 844-52.
  3. Misch CE: Int J Oral Implantol 1990; 7(1): 9-17.
  4. Chiapasco M: Clin Oral Implants Res 2008; 19(4): 416-28.
  5. Chen S, et al.: ITI Treatment Guide 2011; Vol 5,  Quintessenz Publishing.
  6. Pubmed September 2013. Search term “Bio-Oss” and “Sinus”.
  7. Aghaloo TL, Moy PK: Int J Oral Maxillofac Implants 2007; 22: 49-70.
  8. Pjetursson BE, et al.: J Clin Periodontol 2008; 35 (Suppl. 8): 216-40.

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