Long-term stability of transcrestal sinus augmentation

Abstract

Transcrestal sinus augmentation has emerged as a minimally invasive alternative to lateral window techniques for vertical bone augmentation in the edentulous maxilla. Since its early introduction and modification over the last several decades, this technique has demonstrated predictable outcomes for implant placement in regions with limited bone height. This narrative review examines the current understanding and evolution of transcrestal sinus floor elevation (TSFE), focusing on factors related to long-term stability. We evaluate the procedure's foundational principles, including osteotome-mediated bone condensation and controlled fracture of the sinus floor, which contribute to enhanced primary implant stability. The review addresses critical aspects of treatment planning, surgical execution, and postoperative management while examining potential complications and their resolution. Special attention is given to emerging technologies and materials that may influence treatment outcomes. By synthesizing current evidence and clinical experience, this review aims to provide clinicians with a comprehensive framework for optimizing TSFE procedures and managing potential complications, ultimately working toward a standardized approach through a proposed clinical checklist. Finally, we provide a standardized checklist for TSFE outcome reporting in research studies to facilitate more consistent, reproducible, and comprehensive documentation of surgical procedures, complications, and long-term stability.

Keywords: Schneiderian membrane; sinus floor augmentation; sinus grafting; sinus lift; transcrestal technique.