Course:

The lateral window osteotomy (LWO) has been the most frequently utilized and published approach to sinus augmentation, presumably because there are no bone height restrictions and it provides the surgeon with more visual control; it is however, considered to be invasive, time consuming ,expensive and associated with patient morbidity. As a less invasive alternative to the LWO, transcrestal osteotome, balloon and hydrodynamic techniques can obtain a localized elevation of the sinus floor through a 3 to 10 mm diameter crestal osteotomy, minimizing the degree of flap elevation and eliminating the need for preparation of a larger bony window in the lateral aspect of the alveolus. Procedural modifications, innovative instrumentation, autologous growth factors and preoperative CBCT analysis have made both approaches to Sub Antral Floor elevation safer, faster, simpler and more predictable. . Osseodensification is a novel, bio-mechanical, non-excavation osteotomy preparation method. Unlike traditional bone drilling technologies, osseodensification does not excavate bone tissue. Rather, it preserves bone bulk, so bone tissue is simultaneously compacted and autografted in an outwardly expanding direction to form the osteotomy. By Auto compacting and elevating patient’s own bone in the posterior maxillary osteotomy site a moderate sinus elevation is achieved .By applying additional graft material into the osteotomy and propelling it counter clockwise with the densifying burs additional elevation is achieved. The presentation will show the evolution is sinus augmentation approaches and will focus on current step by step Osseodensification sub crestal sinus elevation with long term follow ups of both clinical and CBCT radiographs.