Dr. In-Soon Park, JDIR issue (Minimally Invasive Implant Placement wit…
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Dr. In-Soon Park, JDIR issue (Minimally Invasive Implant Placement with Flapless Transcrestal Sinus Floor Elevation in Thin and Narrow Posterior Maxillary Ridges: A Patient-Driven Healing Approach)
Purpose:
Implant placement in the posterior maxilla is often complicated by severe ridge resorption and sinus pneumatization. In sites with extremely thin and narrow residual bone, flap elevation, grafting, and membrane coverage are commonly recommended. This case report presents a minimally invasive flapless approach and introduces the concept of “Patient-driven Healing Surgery,” which incorporates the patient’s physiological healing potential into treatment planning.
Case Presentation:
Three posterior maxillary sites with residual bone heights of less than 4 mm were treated using transcrestal sinus floor elevation with a Magic Sinus Lifter or Magic Lifter. Flapless implant placement was performed using tissue-over-level MagiCore implants. Although palatal thread exposure was anticipated and confirmed radiographically, no additional graft material or barrier membrane was applied over the exposed threads. Prosthetic rehabilitation was completed after achieving adequate implant stability.
Results:
All implants remained clinically stable during follow-up without significant complications. Serial CBCT examinations demonstrated progressive inclusion of previously exposed palatal implant threads within radiopaque mineralized tissue. Long-term observations showed maintenance of peri-implant stability and favorable healing outcomes.
Conclusion:
Flapless transcrestal sinus floor elevation may be a feasible minimally invasive option in carefully selected posterior maxillary sites with limited residual bone. When primary stability, space maintenance, controlled sinus elevation, and soft-tissue sealing are achieved, physiological healing may contribute to bone recovery around exposed implant threads. The Patient-driven Healing concept may provide a useful framework for reducing surgical invasiveness while maintaining favorable clinical outcomes.
https://doi.org/10.54527/jdir.2026.45.3.23
Purpose:
Implant placement in the posterior maxilla is often complicated by severe ridge resorption and sinus pneumatization. In sites with extremely thin and narrow residual bone, flap elevation, grafting, and membrane coverage are commonly recommended. This case report presents a minimally invasive flapless approach and introduces the concept of “Patient-driven Healing Surgery,” which incorporates the patient’s physiological healing potential into treatment planning.
Case Presentation:
Three posterior maxillary sites with residual bone heights of less than 4 mm were treated using transcrestal sinus floor elevation with a Magic Sinus Lifter or Magic Lifter. Flapless implant placement was performed using tissue-over-level MagiCore implants. Although palatal thread exposure was anticipated and confirmed radiographically, no additional graft material or barrier membrane was applied over the exposed threads. Prosthetic rehabilitation was completed after achieving adequate implant stability.
Results:
All implants remained clinically stable during follow-up without significant complications. Serial CBCT examinations demonstrated progressive inclusion of previously exposed palatal implant threads within radiopaque mineralized tissue. Long-term observations showed maintenance of peri-implant stability and favorable healing outcomes.
Conclusion:
Flapless transcrestal sinus floor elevation may be a feasible minimally invasive option in carefully selected posterior maxillary sites with limited residual bone. When primary stability, space maintenance, controlled sinus elevation, and soft-tissue sealing are achieved, physiological healing may contribute to bone recovery around exposed implant threads. The Patient-driven Healing concept may provide a useful framework for reducing surgical invasiveness while maintaining favorable clinical outcomes.
https://doi.org/10.54527/jdir.2026.45.3.23
- 이전글JDIR issue (Success Criteria for Dental Implants Over the Past 48 Years)
- 다음글Sangyoon Park (Maxillary Full-Arch Rehabilitation without Sinus Augmentation in an Elderly Patient with Systemic Diseases)
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