Georg Watzek: The sinus lift procedure for the edentulous patient - risky overtreatment or reliable necessity

Dr Watzek compares implant treatment with and without sinus lift augmentation procedures from the aspects: relative and absolute contra-indications, intra-operative risks, treatment time frame, success rate and cost. As a general rule, the smaller the surgical intervention, the lower risk for complications. Complications in sinus lift procedures can be e.g. medical condition of patient, interference of intervention with medication, local anatomical conditions such as sinus septae, perforation of vessels and subsequent bleeding, perforations of membrane and subsequent local infection and foreign body dislocation into sinus. The rare randomized controlled data available on implant placement with sinus lift indicate an implant success rate of ~92 % which is lower than the success rate of implants without sinus augmentation of ~97 %. In comparison, an All-on-4 solution requires only one surgical intervention and intra-operative risks are low, with the sliding up phenomenon and malplacement of the implant in immediate implant situations as the most pronounced complication. Dr Watzek concludes that both treatment approaches have the same esthetic and functional outcome, however that the All-on-4 approach offers a low invasive one surgery protocol, considerably lower risk and complication potential, as well as lower cost.