Minimally invasive sinus elevation techniques in implant dentistry (Review)

Implant placement in the posterior maxilla is often complicated by reduced vertical bone height due to alveolar resorption and maxillary sinus pneumatization. Traditionally addressed by the lateral window sinus lift, this invasive approach has evolved with the advent of minimally invasive sinus elevation (MISE) techniques aimed at reducing surgical trauma and enhancing patient outcomes. The present review discusses contemporary MISE methods, including osteotome-based, hydraulic, balloon-assisted, piezoelectric and guided techniques, highlighting their clinical indications, protocols and comparative advantages. With residual bone heights of 4-8 mm, these methods enable safe, predictable sinus membrane elevation, while often permitting simultaneous implant placement. Enhanced by technologies such as cone-beam computed tomography imaging, endoscopic guidance and dynamic navigation systems, MISE provides precision and safety in anatomically or medically complex cases. By integrating digital planning and biologic adjuncts, these techniques align with the goals of patient-centered, minimally invasive implantology. A comprehensive literature search was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases, covering articles published between 2010 and 2025. Relevant studies were identified using key words related to minimally invasive sinus elevation, crestal approach and implant placement in the posterior maxilla. Overall, MISE techniques are becoming a critical component of modern implant practice, providing predictable clinical outcomes with reduced morbidity, improved patient comfort and enhanced surgical precision.