Maxillary Sinus Elevation Using the Modified Summers Technique: Report of Two Clinical Cases with more than 10 Years of Follow-up

Abstract

Aims: The present study reports the long-term clinical outcomes of maxillary sinus floor elevation performed using a modified Summers osteotome technique in sites with residual bone height below that traditionally recommended, through the presentation of two clinical cases with follow-up periods of 14 and 9 years. Study Design: Clinical case reports with long-term follow-up. Place and Duration of Study: Brazilian Dental Association – Regional Santos, Santos, São Paulo, Brazil. Case 1: October 2009 to October 2023. Case 2: April 2015 to April 2024. Methodology: Two female patients presenting posterior maxillary edentulism and residual bone height ranging from 3 to 6 mm underwent transcrestal maxillary sinus floor elevation using a modified Summers technique. The surgical protocol included strategic palatal positioning of drills, reduced-depth sequential drilling, use of osteotomes, and grafting with hydroxyapatite, associated with autogenous bone in one case. Implants were placed simultaneously, and prosthetic rehabilitation was performed after a 6-month osseointegration period. Results: Primary stability values of 43 and 45 N·cm were achieved in Case 1, and 35 N·cm in Case 2. The transcrestal technique demonstrated expressive bone gain, exceeding the initial native bone height in all evaluated regions, with a 100% success rate and no reported complications or implant loss after 14 and 9 years of follow-up, respectively. Conclusion: The modified Summers technique proved to be a safe, predictable and minimally invasive approach for implant placement in posterior maxillary regions with residual bone height below 6 mm when adequate planning and case selection are applied.