Maxillary sinus augmentation using computer-aided design/computer-aided manufacturing (CAD/CAM) technology

Background: Maxillary sinus augmentation is a common method for increasing bone height for insertion of dental implants. In most cases, the graft is manually cut into a roughly appropriate shape by visual estimation during the operation; accordingly, the shape of the graft depends considerably on the experience of the surgeon. We have developed a computer-aided design/computer-aided manufacturing (CAD/CAM) technique to generate custom-made block grafts for sinus augmentation, and a customized cutting guide to precisely position the lateral wall and facilitate membrane elevation, using cone-beam computed tomography (CBCT). Methods: Custom-made blocks of hydroxyapatite (HA) were preoperatively cut to the required shape, based on a three-dimensional (3D) simulation, using CAD/CAM technology. The custom-made HA blocks were used for sinus augmentation. Results: Five patients underwent bilateral sinus elevation with custom-made HA blocks. Six months later, implants were placed. Two years after placement, all implants were in function. No clinical or prosthetic complications were encountered. Conclusions: We present a CAD/CAM technique for the fabrication of custom-made block grafts for sinus augmentation.