Lateral Antrostomy Integrated with Digital Approach (LAIDA): A Case Report and Literature Review

Traditionally, surgeons rely on manual measurements to translate pre-surgical plans into clinical reality during sinus floor elevation with a lateral approach. Standardizing this surgical phase could offer a reproducible technique minimizing operational errors and ensuring more consistent and predictable outcomes.

This case report presents a comprehensive digital approach integrating lateral antrostomy (LAIDA) for the elevation of the maxillary sinus floor.

Lateral sinus floor elevation was required for a 61-year-old patient. A detailed digital protocol, integrating artificial intelligence, was employed to create a tooth-supported surgical guide for antrostomy. Under local anaesthesia, a full-thickness flap was elevated to expose the lateral sinus wall. The surgical guide was accurately positioned, and the antrostomy area was marked on the bone wall. The bony window was then performed using round diamond burs, and the Schneiderian membrane was gently lifted until the medial wall of the sinus was exposed. The sub-antral space was filled with a composite graft, and three implants were placed using the same surgical guide. The antrostomy was covered using a resorbable collagen membrane, and flaps were sutured with synthetic monofilament. No intra- and post-operative complications were recorded.

Accurate antrostomy planning and execution are crucial, considering factors, like sinus floor location, presence of alveolar-antral artery, and Underwood septa. The present study emphasizes the benefits of a standardized approach using a 3D-printed surgical guide, aiding real-time visualization of the predetermined bony window during surgery. The LAIDA workflow may help in minimizing intra-operative complications, enhancing patient comfort and improving surgical outcomes.