scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Hydrodynamic ultrasonic maxillary sinus lift: review of a new technique and presentation of a clinical case.

TL;DR: The main advantage of this new technique, Intralift, is that it does not require a minimum amount of crestal bone and the possibility of damage to the sinus membrane is minimised by using ultrasound based hydrodynamic pressure to lift it, while applying a very non-aggressive crestal approach.
Abstract: Objectives: Placing implants in the posterior maxillary area has the drawback of working with scarce, poor quality bone in a significant percentage of cases. Numerous advanced surgical techniques have been developed to overcome the difficulties associated with these limitations. Subsequent to reports on the elevation of the maxillary sinus through the lateral approach, there were reports on the use of the crestal approach, which is less aggressive but requires a minimal amount of bone. Furthermore, it is more sensitive to operator technique, as the integrity of the sinus membrane is checked indirectly. The aim of this paper is to review the technical literature on minimally invasive sinus lift and compare the advantages of different techniques with Intralift™, a new technique. Study Design: The present study is a review of techniques used to perform minimally invasive sinus lift published in Cochrane, Embase and Medline over the past ten years and the description of the crestal sinus lift technique based on minimally invasive piezosurgery, with the example of a case report. Results: Only eight articles were found on minimally invasive techniques for sinus lift. The main advantage of this new technique, Intralift, is that it does not require a minimum amount of crestal bone (indeed, the smaller the width of the crestal bone, the better this technique is performed). The possibility of damage to the sinus membrane is minimised by using ultrasound based hydrodynamic pressure to lift it, while applying a very non-aggressive crestal approach. Conclusions: We believe that this technique is an advance in the search for less traumatic and aggressive techniques, which is the hallmark of current surgery. Key words: Sinus lift, surgical technique, minimally invasive surgery, ultrasound surgery.

Content maybe subject to copyright    Report

Citations
More filters
Journal ArticleDOI
TL;DR: Although both osteotome and lateral window procedures can help clinicians in overcoming the challenges of placing implants in atrophic posterior maxilla, pre-implant residual bone height is crucial in determining the survival of these implants.
Abstract: Background Sinus lift procedures are used to allow residual bone to accommodate functional implants in atrophic posterior maxilla. Numerous anatomical and surgical advancements in sinus lift surgery are still inspiring clinicians. Purpose The purpose of this study was to describe the recent trends in sinus lift surgery focusing on implant survival, bone grafting, anatomical and surgical considerations, and their clinical implications on the practice of implant dentistry in atrophic posterior maxilla. Materials and Methods We performed an extensive search in MEDLINE, Embase, Scopus, Web of Science, Trip, Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses. Articles were critically reviewed to determine the level of evidence as per the Canadian Task Force on Preventive Health Care. Results Comprehensive assessment of sinus septa, sinus pathology, and bone quality and quantity using three-dimensional cone beam computed tomography radiographs is important before placing implants in posterior maxilla. With a residual bone height of less than 5 mm, the survival rate of implant decreases substantially. Lateral window approach can increase the vertical bone height to greater than 9 mm, while osteotome approach can increase this height from 3 to 9 mm. The perforation of Schneiderian membrane doubles the risk for the incidence of sinusitis or infection. The use of piezoelectric surgery allows adequate sinus lift while protecting soft tissues and minimizing patient discomfort. Conclusions Although both osteotome and lateral window procedures can help clinicians in overcoming the challenges of placing implants in atrophic posterior maxilla, pre-implant residual bone height is crucial in determining the survival of these implants. Future research directions should consider study designs grounded on longitudinal randomized controlled trials of large sample size.

62 citations

Journal ArticleDOI
TL;DR: The results of this paper prove the key role of the sinus membrane as the main carrier of bone reformation after sinus lift procedures as multiple experimental studies suggested and the importance of minimal invasive and rupture free sinuslift procedures is underlined and does not depend on the type of grafting material used.
Abstract: Introduction. Sinus lift procedures are a commonly accepted method of bone augmentation in the lateral maxilla with clinically good results. Nevertheless the role of the Schneiderian membrane in the bone-reformation process is discussed controversially. Aim of this study was to prove the key role of the sinus membrane in bone reformation in vivo. Material and Methods. 14 patients were treated with the minimal invasive tHUCSL-Intralift, and 2 ccm collagenous sponges were inserted subantrally and the calcification process followed up with CBCT scans 4 and 7 months after surgery. Results. An even and circular centripetal calcification under the sinus membrane and the antral floor was detected 4 months after surgery covering 30% of the entire augmentation width/height/depth at each wall. The calcification process was completed in the entire augmentation volume after 7 months. A loss of approximately 13% of absolute augmentation height was detected between the 4th and 7th month. Discussion. The results of this paper prove the key role of the sinus membrane as the main carrier of bone reformation after sinus lift procedures as multiple experimental studies suggested. Thus the importance of minimal invasive and rupture free sinuslift procedures is underlined and does not depend on the type of grafting material used.

26 citations

Journal ArticleDOI
TL;DR: The results of the present study suggest tHUCSL-INTRALIFT should be used to perform predictable and safe detachment of the periosteum from the bony sinus floor as a prerequisite for undisturbed and successful physiologic subantral bone regeneration.

17 citations

Journal ArticleDOI
TL;DR: HUCSL represents a good alternative method for Sinus floor elevation and resulted in a significantly higher sinus floor augmentation in the mesio-distal and bucco-palatal direction compared with the osteotome technique.
Abstract: The implant-supported prosthetic rehabilitation of the posterior maxilla may require sinus-grafting procedures due to poor quality and low volume of bone. This can be accomplished using a “lateral window” sinus augmentation or with an osteotome sinus floor elevation (OSFE). The hydrodynamic ultrasonic cavitational sinus lift (HUCSL) (Intralift) is derived from the osteotome technique and allows the reduction of some of the traumatic effects of the osteotome technique. The aim of this study was to compare OSFE and the HUCSL procedures on fresh human cadaver heads. Primary outcomes were the height and width of the grafting area in the sinus floor area. Eighty-four maxillary sinuses were selected. On each fresh cadaver head, 2 sinus lifts were done using OSFE and HUCSL in the maxillary sinuses. Computerized tomography scans were performed on each head before and after the surgeries. Measurements were done on radiologic pictures using dedicated software, and the integrity of the sinus membrane was observed af...

9 citations

Journal ArticleDOI
TL;DR: The results suggest the tHUCSL to be a safe minimal-invasive alternative to traditional lateral approach and transcrestal osteotome sinuslift-procedures applicable to all anatomical situations.
Abstract: Introduction: In 2006 an ultrasound-surgery-based method to hydrodynamically detach the sinus-membrane utilizing the ultrasonic cavitation effect—the tHUCSL—was developed and a surgical protocol established. The aim of the study was to determine the indication-range and success-rate of this novelty procedure. Materials & Methods: Between 2007 and 2009, 404 patients were treated by 6 oral surgeons of different experience-levels with the tHUCSL in 446 sinussites. 637 implants were inserted and then prosthodontically treated and observed and documented until December 2011. The subantral space was augmented via the 3 mm transcrestal approach with an augmentation volume of 1.9 ccm (+/− 0.988 ccm) and an augmentation height of 10.7 mm (+/− 2.85 mm). Results: Within the survey-period 15 (2.35%) of the 637 inserted implants were lost, mostly before implant loading due to postsurgical infection and nonosseointegration in the augmentation site. 1 implant was lost after implant loading and prosthetic treatment within 1 year after loading. The overall success rate with functional implants in site is 97.65% evenly distributed among the participating surgeons. 86% of the patients were observed with no postsurgical swelling and 87% no postsurgical pain. Discussion: The results suggest the tHUCSL to be a safe minimal-invasive alternative to traditional lateral approach and transcrestal osteotome sinuslift-procedures applicable to all anatomical situations.

8 citations


Cites methods from "Hydrodynamic ultrasonic maxillary s..."

  • ...To combine the advantages of a lateral approach sinuslift (scalable augmentation area and volume) with the atraumaticity of the transcrestal approach and to avoid the need of the surgeon to touch the sinus membrane with instruments or balloons in the detachment-process (and therewith eliminate one of the major risks of intrasurgical membrane perforation) and to utilize the well documented advantages of hydrodynamic pressure sinusmembrane-detachment [36,37] and atraumaticity of ultrasonic surgery, the transcrestal hydrodynamic ultrasonic cavitational sinuslift (tHUCSL-INTRALIFT) was developed in 2006 [38-40]....

    [...]

References
More filters
Journal ArticleDOI
Arun Garg1
TL;DR: In patients with an inadequate amount of bone for implant placement, sinus lift surgery can be performed to restore a sufficient amount of alveolar bone to allow for successful implant placement and subsequent prosthetic reconstruction.
Abstract: In patients with an inadequate amount of bone for implant placement, sinus lift surgery can be performed to restore a sufficient amount of alveolar bone to allow for successful implant placement and subsequent prosthetic reconstruction. In this article, the anatomy and physiology of the maxillary sinus, the mechanisms of bonegrafting, bone grafting material, preoperative evaluation, surgical technique, and the grafting procedure, as well as intraoperative bleeding and postoperative complications, are discussed. (Implant Dent 1999;8:36–46)

120 citations

Journal Article
TL;DR: The procedure may provide important advantages over conventional ostectomy using diamond drills, as it reduces the risk of perforating the Schneiderian membrane, improves vision and hygiene of the operating area, and provides a more conservative and controlled osseous incision.
Abstract: Because of its physical and mechanical properties, the odontologic applications of ultrasound are increasing. A new application of odontologic ultrasonic generators involves the lateral approach of the maxillary sinus in sinus augmentation. The procedure may provide important advantages over conventional ostectomy using diamond drills, as it reduces the risk of perforating the Schneiderian membrane, improves vision and hygiene of the operating area, and provides a more conservative and controlled osseous incision. (INT J ORAL MAXILLOFAC IMPLANTS 1998;13:697‐700)

113 citations

Journal ArticleDOI
TL;DR: This article reviews techniques of sinus lift and presents advantages, disadvantages and success rates where available and suggests selection of technique should be done cautiously based on long-term results.

98 citations

Journal ArticleDOI
TL;DR: The antral membrane balloon elevation technique, which is introduced in this preliminary report, is a modification of the currently used sinus lift that elevates the membrane easily and makes the antral floor accessible for augmentation with grafting materials.
Abstract: Many edentulous posterior maxilla are found to be encumbered by alveolar resorption and increased pneumatization of the sinus. These factors limit the quantity and quality of bone necessary for successful implant placement in these areas. One solution is to use shorter implants, but this often results in an unfavorable crown-root ratio. To create an improved environment in such regions, the classic sinus floor elevation with bone augmentation is a well-accepted technique. However, when the edentulous area is limited to a zone between 1 and 2 teeth, lifting the membrane becomes difficult and may subject it to iatrogenic injury. The antral membrane balloon elevation technique, which is introduced in this preliminary report, is a modification of the currently used sinus lift. It elevates the membrane easily and makes the antral floor accessible for augmentation with grafting materials.

73 citations

Journal ArticleDOI
TL;DR: The protocol of MIAMBE results in an excellent success rate, low complication rate, minimal discomfort, and long-term safety and durability, and this clinical approach should be widely employed.
Abstract: The posterior maxillary segment frequently suffers from insufficient bone mass to support dental implants. Current bone augmentation methods, including the lateral maxillary approach (ie, hinge osteotomy) and sinus elevation by osteotome, have many shortcomings. The objective of our study was to assess the safety and efficacy of minimally invasive antral membrane balloon elevation (MIAMBE) followed by bone augmentation and implant fixation (executed during the same procedure). Alveolar crest exposure and implant osteotomy were followed by sequential balloon inflations yielding >10 mm MIAMBE. A mix of autologous fibrin and bone particles with bone speckles was injected beneath the antral membrane. Implants were fixated into the osteotomies, and primary closure was performed during the same sitting. A total of 24 patients were enrolled. Successful conclusion of this procedure was accomplished in 91.6% of the initial 12 patients and 100% in the second dozen cases without significant complications. P...

65 citations