Enhancing Precision and Outcomes in Sinus Lift Surgery: The Role of Static Surgical Guides for the lateral window approach in Sinus Augmentation

Aim: To evaluate the clinical efficacy and accuracy of using static surgical guides in lateral window sinus lift procedures for dental implant placement in patients with severely resorbed posterior maxilla.

Materials and Methods: This prospective case series was conducted at Saveetha Dental College and Hospital, Chennai, from October 2024 to April 2025. Three patients (2 females, 1 male; mean age 48.3 ± 6.2 years) with posterior maxillary partial edentulism and residual bone height less than 5 mm were subjected to sinus augmentation using patient-specific static surgical guides. Preoperative planning involved cone-beam computed tomography (CBCT) and intraoral digital scanning, which were merged using ExoPlan software to design and fabricate the surgical guides. Lateral window osteotomies were performed using round burs under the guidance of the printed templates. Sinus membrane elevation, bone grafting with xenograft (Bio-Oss), and membrane placement (Creos) were performed in all cases. Implant placement was either simultaneous or delayed based on residual bone height.

Discussion: Static surgical guides enabled precise transfer of the virtual surgical plan into the clinical setting, allowing accurate osteotomy window placement while avoiding critical anatomical structures such as the Schneiderian membrane, antral artery, and sinus septa. Membrane elevation was successfully completed without perforation in all three cases. The guided approach enhanced graft containment, minimized complications, and facilitated accurate implant positioning with high primary stability. The digital workflow also contributed to improved surgical efficiency, reduced operative stress, and positive patient-reported outcomes. These findings align with existing literature supporting the benefits of guided surgery in complex maxillary procedures.

Conclusion: The use of static surgical guides in lateral window sinus lift surgeries offers a reliable, accurate, and minimally invasive approach for augmenting severely resorbed posterior maxillae. This technique reduces the risk of complications, improves graft placement, and supports predictable implant outcomes. Despite the limited sample size, results suggest that digital-guided sinus augmentation is a promising modality for complex implant cases and warrants further investigation through larger-scale studies.

Keywords: Static surgical guide, sinus lift, lateral window osteotomy, maxillary sinus augmentation, CBCT, guided implant surgery, digital workflow, Bio-Oss, posterior maxilla.