Maxillary sinus floor elevation techniques, advanced biomaterials, and complication management protocols in implant dentistry: A comprehensive review

Maxillary sinus floor elevation stands as a highly predictable surgical treatment modality that successfully overcomes severe vertical bone deficiencies in the posterior maxilla. This review evaluates the anatomical structural parameters of the adult maxillary sinus, surgical pathways including lateral window antrostomy and transcrestal osteotome procedures, and contemporary advancements in biomaterials and digital navigation technologies. The adult maxillary sinus presents an average total volume of 15 mL, structurally segmented by bony or membranous septa. Blood supply is sustained via an arterial arcade formed by the posterior superior alveolar and infraorbital arteries. Meticulous preoperative three-dimensional imaging and accurate identification of anatomical variations are essential to safely navigate the lateral wall endosseous pathways. Intraoperative complications, primarily Schneiderian membrane perforations occurring in 20–25% of open lateral window procedures, require systematic, size-dependent classification and repair strategies. Quantitative three-dimensional assessments confirm predictable vertical ridge height increases using distinct graft matrices, including nanohydroxyapatite and deproteinized bovine bone. Furthermore, advanced transcrestal variations—such as hydrodynamic systems—and the integration of artificial intelligence-driven planning software significantly reduce postoperative patient morbidity while enhancing surgical precision and long-term implant survival rates.