Schneiderian Membrane Elevation up to 8 mm by Transcrestal Technique Using Hollowed Osteotomes: A Human Cadaver Study

Purpose The objective of this study was to compare the detachment surfaces of Schneiderian membrane elevation of 4–8 mm by transcrestal technique using hollowed osteotomes on human cadavers with 4 mm residual bone height. Methods The study followed the CACTUS (ChAracteristics of Cadaver Training and sUrgical Studies) guidelines. Thirty‐four heads with maxillary bilateral edentulous posterior zones and type IV bone (a residual bone height of 4 mm) were selected using cone beam computed tomography (CBCT) scans. Heads were randomly allocated to a group and both sinuses received the same treatment. A sinus floor elevation was performed on the 68 sites using new hollowed osteotome (C.M.C Tech, IBS Implant, Daejeon, South Korea). Samples were divided into two groups: Group 1: sinus elevation of 4 mm; and Group 2: sinus elevation of 8 mm. A postoperative CBCT was performed to analyze membrane integrity and to assess the membrane detachment in mesiodistal and buccopalatal plane. Results Of the 68 membrane elevations, only 4 were associated with perforations; 2 occurred in each group. The detachment surface variations between group 1 and group 2 were linear in all directions (Pearson correlation coefficient ρ = 0.99). The Student's t ‐test unveiled significant differences in detachment surfaces between group 1 and group 2 in all directions ( p < 0.001). The ratio of detachment surface group 2/group 1 was homogeneous in all directions (1.5 ≤ r ≤ 1.54). The quality of Schneiderian membrane elevations of 4–8 mm by transcrestal technique was similar using the hollowed osteotomes on human cadavers with 4 mm residual bone height. Conclusions In a transcrestal approach using this new‐generation osteotome, sinus membrane elevations of 8 mm were performed with a low perforation rate in cadavers. The use of the new hollowed osteotome allowed a Schneiderian membrane elevation of up to 8 mm in a safe and reproducible manner. This transcrestal elevation protocol could increase the indications of the technique, especially concerning single implant restorations and for frail patients with significant medical history for whom a lateral approach would be too invasive.