Application of Dynamic Navigation System to Simultaneous Crestal Sinus Lifting and Dental Implant Placement at Maxillary Molars: Report of Two Cases

Abstract: Objectives: Various dynamic navigation systems have been developed to enhance the accuracy of implant positioning and prevent damage to anatomical structures such as the inferior alveolar nerve and maxillary sinus during osteotomies. This case report aims to demonstrate a surgical method that combines a dynamic navigation system with crestal sinus lifting and simultaneous implant placement in the maxillary molar region. Materials and Methods: Two systemically healthy patients with extraction and socket preservation of a hopeless maxillary second molar were included in the study. Preoperative cone-beam computed tomography (CBCT) revealed limited residual bone height for implant placement after the healing period. Virtual planning of the implant was conducted using dynamic navigation planning software. Both patients underwent crestal sinus lifting through hydraulic pressure and simultaneous single implant placement assisted by the dynamic navigation system. Postoperative CBCT was performed 6 to 7 months after the implant placement to evaluate the implant position and increase in bone height. The postoperative implant position and orientation were compared to the preoperative virtual plan. Results: In both cases, the surgeries were uneventful and no postoperative complications occurred. Postoperative evaluation revealed that the global platform deviation was 1.60 and 2.24 mm, the global apex deviation was 1.46 and 2.13 mm, and angular deviation was 1.18° and 5.50° in case 1 and case 2, respectively. Conclusion: Combined dynamic navigation system with crestal sinus lifting by hydraulic pressure and simultaneous implant placement is a safe, accurate, and reduced morbidity surgical protocol in the maxillary molar region.