In the attempt to reduce the invasiveness of a transcrestal sinus floor elevation procedure, different aspects must be considered; that is, the minimization of intra‑ and postsurgery morbidity, the reduction of treatment time, and the simplification/elimination of the reconstructive technology. Within this context, a systematic literature search was performed for controlled clinical trials evaluating the impact of one or more of these aspects on transcrestal sinus floor elevation invasiveness. Nineteen articles (15 studies) were included. Overall, the results confirmed that transcrestal sinus floor elevation is a minimally invasive and effective option for bone augmentation in the edentulous, atrophic posterior maxilla. By using powered instruments rather than manual osteotomes and hand mallet, the invasiveness of transcrestal sinus floor elevation can be further reduced without affecting its clinical effectiveness. To impact effectively on morbidity, the key elements to consider when selecting instruments for transcrestal sinus floor elevation are (a) their availability as a standardized sequence, to be adapted on predetermined residual bone height, and (b) the possibility to control pressure (eg, with screwable osteotomes) and/or instrument excursion (eg, with stop devices) to fracture the maxillary sinus floor. Among powered instruments, a standardized sequence of drills incorporating a trephine drill seem to be particularly indicated, due to reduced chair time, high tolerability for the patient, and the possibility to isolate a bone core to implement histomorphometric outcomes. At molar extraction sites with an interradicular septum characterized by a height of at least 4 mm, immediate transcrestal sinus floor elevation and implant placement can be considered a valid option to shorten treatment time.

中文翻译：

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上颌窦底经牙槽嵴顶抬高术的微创：系统评价

在尝试减少经牙槽嵴底抬高手术的侵入性时，必须考虑不同的方面；也就是说，最大限度地减少术中和术后发病率、减少治疗时间以及简化/消除重建技术。在此背景下，对评估这些方面中的一个或多个对经牙槽嵴底抬高侵入性的影响的对照临床试验进行了系统的文献检索。包括 19 篇文章（15 项研究）。总体而言，结果证实，经牙槽嵴顶窦底抬高术是一种微创且有效的选择，可用于无牙颌、萎缩性后颌骨的骨增量。通过使用动力器械而不是手动骨凿和手槌，在不影响其临床疗效的情况下，可进一步降低经牙槽嵴顶窦底抬高术的侵入性。为了有效地影响发病率，在选择用于经牙槽嵴底窦底抬高的仪器时要考虑的关键因素是 (a) 它们作为标准化序列的可用性，根据预定的残余骨高度进行调整，以及 (b) 控制压力的可能性（例如, 用螺旋骨凿) 和/或器械偏移 (例如, 用止动装置) 来骨折上颌窦底。在动力器械中，由于减少了椅旁时间、患者的高耐受性以及分离骨芯以实现组织形态学结果的可能性，似乎特别指出了包含环钻的标准化钻孔序列。