Hydraulic sinus lift with sinus condensers.

Successful tooth extraction, socket preservation, site development, sinus augmentation, and implant placement in the posterior maxilla traditionally have required multiple appointments over 18-24 months. A hydraulic sinus-condensing technique enables such procedures to be performed in a single surgical visit, reducing patient trauma and recovery time. Over the last five years, C. Leon Chen, DMD, MS, adjunct professor at the University of Nevada, Las Vegas, School of Dentistry and director of the Dental Implant Institute of Las Vegas, has used a hydraulic sinus lift technique in more than 258 implant cases (Lifecore RBM Implants). All but one succeeded and only four required repair. Chen believes that the hydraulic procedure often is the technique of choice "based on its broad-based scope of application in extraction, site preservation/development, and immediate implant cases."

Overview: Sinus Augmentation

Anatomical limitations often associated with the posterior maxilla include a flat palatal vault, deficient alveolar height, inadequate posterior alveolus, increased pneumatization of the maxillary sinus, and close approximation of the sinus to crestal bone. Maxillary bone, primarily medullary and trabecular, has less quantity and osseous density than the premaxilla or mandible. Adjacent cortices of compact bone generally are very thin, providing minimal strength.

Chen notes that the maxillary sinus is of particular concern when implant treatment is considered for posteriorly edentulous patients because pneumatization of the sinuses frequently minimizes or completely eliminates vertical bone availability for implants. If there is sufficient alveolar bone height and only partial pneumatization of the sinus, bone grafting and implant placement can be performed simultaneously. The implant can be placed through the crestal bone into the graft material provided there is at least 5 mm of alveolus present to stabilize the implant during the healing period.

Several techniques, …