Fig. 10

Palatal approach lateral window sinus augmentation. This photographic series shows the surgical procedure that augmented bone and allowed implant placement at the no. 14 site. a Preoperative view prior to infiltration anesthesia. b Full-thickness midcrestal incision with palatal release and flap elevation. This was aided by a small bony ridge that separated the alveolar crest from the soft tissue area containing the greater palatine neurovascular bundle. c Sinus window created with piezosurgery. d–f With gentle piezocision and water pressure, the finger-like membrane is slowly mobilized and collapsed towards the remainder of the sinus cavity. The overlying bone serves to form a new floor covering the base of the finger-like cavity. f Conventional implant placement using osteotomy drills. g Any exposed sinus membrane is covered with collagen tape. h Particulate mineralized allograft is placed into the newly created space. i A resorbable collagen membrane is placed over the access window. j Palatal tissue is sutured over implant and grafted site with mattress sutures. k Postoperative radiograph taken immediately after surgery shows cloud of particulate grafted bone around implant, suggesting good bone graft containment