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

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.

Figures

Figure 1

(A) TKW1 tip, (b) TKW2 tip, (c) TKW3 tip, (d) TKW4 tip, (e) TKW5 tip, also called 'Trumpet'.

Figure 2

(A) Preoperative periapical X-ray, (b) Mixing blood collected from the edges of the incision with augmentation material (Biogen™, Bioteck, Italy) (c) TKW5 tip, also called 'Trumpet', (d) Hole created on the ridge for subsequent use of a TKW5 tip, (e) 4/0 silicone-coated polyester suture, (f) Periapical X-ray of maxillary sinus with augmentation material inserted, (g) Periapical X-ray of the maxillary sinus with augmentation material and implant in place.