title: Paradigm shift in the management of the atrophic posterior maxilla.
abstract: When the posterior maxilla is atrophic, the reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach and delayed implant placement. However, placement of short implants with the osteotome sinus floor elevation technique and without graft can be proposed for an efficient treatment of clinical cases with a maxillary residual bone height of 4 to 8 mm. The use of grafting material is recommended only when the residual bone height is ≤4 mm. Indications of the lateral sinus floor elevation are limited to cases with a residual bone height ≤ 2 mm and fused corticals, uncompleted healing of the edentulous site, and absence of flat cortical bone crest or when the patient wishes to wear a removable prosthesis during the healing period. The presented case report illustrates osteotome sinus floor elevation with and without grafting and simultaneous implant placement in extreme conditions: atrophic maxilla, short implant placement, reduced healing time, and single crown rehabilitation. After 6 years, all placed implants were functional with an endosinus bone gain.
authors.affiliation: Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Rue du Collège 3, 1800 Vevey, Switzerland.
authors.forename: Rabah
authors.identifier: 0000-0003-0706-3082
authors.initials: R
authors.lastname: Nedir
authors.affiliation: Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Rue du Collège 3, 1800 Vevey, Switzerland.
authors.forename: Nathalie
authors.identifier: 0000-0002-1106-4435
authors.initials: N
authors.lastname: Nurdin
authors.affiliation: Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Rue du Collège 3, 1800 Vevey, Switzerland ; Department of Oral and Maxillofacial Surgery, Oral Surgery and Implantology Unit, Geneva University Hospitals, Rue Barthélemy-Menn 19, 1205 Geneva, Switzerland.
authors.forename: Paul
authors.identifier: 0000-0002-3769-3299
authors.initials: P
authors.lastname: Khoury
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oral Surgery and Implantology Unit, Geneva University Hospitals, Rue Barthélemy-Menn 19, 1205 Geneva, Switzerland ; Ardentis Clinique Dentaire Lausanne, Swiss Dental Clinics Group, Voie du Chariot 6, 1003 Lausanne, Switzerland.
authors.forename: Marc
authors.identifier: 0000-0003-3525-0811
authors.initials: M
authors.lastname: El Hage
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oral Surgery and Implantology Unit, Geneva University Hospitals, Rue Barthélemy-Menn 19, 1205 Geneva, Switzerland ; Ardentis Clinique Dentaire Geneva, Swiss Dental Clinics Group, Rue Thomas-Masaryk 1, 1202 Geneva, Switzerland.
authors.forename: Semaan
authors.identifier: 0000-0003-3747-8297
authors.initials: S
authors.lastname: Abi Najm
authors.affiliation: Ardentis Clinique Dentaire Lausanne, Swiss Dental Clinics Group, Voie du Chariot 6, 1003 Lausanne, Switzerland.
authors.forename: Mark
authors.initials: M
authors.lastname: Bischof