Aim: to evaluate clinical and radiologic outcomes using a newly developed device for maxillary sinus membrane elevation.
Materials and Methods: Patients with a residual bone hight of at least 3 mm were enrolled. Crestal sinus lift elevation and sinus graft were performed by using the crestal approach sinus (CAS) kit. Graft was avoided if the residual bone crest was up to 2 mm less than the length of the planned implant. Outcome measures were: implant and prosthesis failure, any biological or technical complications, and marginal bone loss (MBL).
Results: Thirty-five consecutive patients underwent to 49 crestal elevations of the sinus membrane. All the implants were followed for at least 2 years after their placement (mean follow-up 37.3 months; 24–54 months). No implants or prostheses had failed, and no membrane tears or other intraoperative or postoperative adverse events were observed. At 2-year follow-up mean MBL  was 0.33±0.24 mm (95% CI: 0.08–0.30 mm). Thirty-two implants were placed after filling the sinus with anorganic bovine bone while, 17 implants were installed without grafting the sinus. Post-hoc analysis was performed using the sinus grafting remodeling index (SGRI) to evaluate the radiographically tissue remodeling patterns. The SGRI index was statistically significant higher when grafting the sinus (P=0.000).
Conclusions: The crestal approach sinus (CAS) kit may provide a new option for minimally invasive crestal sinus surgery. Long-term randomized controlled trials with larger sample size are needed to confirm these preliminary results.

A newly developed device for maxillary sinus membrane elevation by crestal approach- a 2-year prospective comparative case series study with or without graft material for sinus augmentation