Digital planning and navigation in sinus lifting surgery. (Description of a clinical case)

Background. The presence of bone septa in the maxillary sinus significantly increases the risk of Schneiderian membrane perforation and other complications during sinus lift surgery. Classical techniques in such anatomically complex conditions do not always provide the necessary accuracy and safety, necessitating the development of new personalized approaches using digital planning. Objective. To develop and test a method of open sinus lift with simultaneous dental implantation in a patient with a maxillary sinus septum using a personalized navigational surgical template. Material and methods. This paper presents a clinical case of patient N. with bone deficiency and a 7.7 mm high septum in the area of tooth 1.5. At the planning stage, cone-beam computed tomography (CBCT) data and intraoral scans (STL models) were merged. A virtual 3D simulation of the surgery was performed, based on which two tooth- and mucosa-supported surgical templates were fabricated: the first for precise creation of a bone window bypassing the septum, and the second for accurate implant positioning. An open sinus lift using Bio-Oss bone graft material and dental implant placement were performed. Results. No intraoperative complications (membrane perforation, bleeding) occurred. At the 6-month follow-up, radiological examination confirmed the formation of new bone tissue in the augmented area and successful implant osseointegration. There were no clinical signs of inflammation or mobility of the structure, and the patient was satisfied with the aesthetic and functional result. Conclusions. The use of digital planning and navigational surgical templates allows for safe and predictable sinus lift and implantation in cases of complex maxillary sinus anatomy (presence of high septa). This method minimizes surgical risks and ensures a favorable long-term treatment prognosis, although further study on larger clinical samples is required.