Hydraulic sinus condensing

X-Ray picture of a patient after Hydraulic Sinus Condensation and implant placement

Hydraulic Sinus Condensing (HSC) is a sinus lift procedure invented in 1996, by Dr. Leon Chen of the Dental Implant Institute. Unlike the traditional methods of sinus lifts, which typically use an osteotomy of the lateral aspect of the maxilla, the HSC technique uses an osteotomy on the lateral aspect of the crestal ridge of the maxilla. The HSC technique has shown to have much shorter recovery times than traditional methods, and does not require a hospital visit, or a bed rest recovery time. A dental implant is placed at the same time as the HSC technique, also reducing the healing time.

Procedure

A local anesthetic with vasoconstrictor is infiltrated into the gums, and a crestal incision is made.

An osteotomy is initiated on the crestal ridge with a 5mm Chen Sinus Bur, or a Chen Peizo tip. Drilling ceases about 1mm short of the sinus floor. The surgeon then downsizes to a 2mm Chen sinus bur for the purpose of forming a narrower conical shape at the end of the osteotomy. Constant pressure is applied to the foot pedal of the high speed hand piece to apply hydraulic pressure to the osteotomy while drilling.

While rotating, the 2mm Sinus bur is gently tapped through the cortical bone of the sinus floor, just hard enough form a pinhole through the bone. Hydraulic pressure is introduced to the surgical site at this stage, providing just enough force to begin atraumatically dissecting the membrane from the sinus floor. Once the membrane is loosened, the hydraulic pressure is ceased. The membrane will be at rest, but slightly detached.

The patient is now ready for the initial lifting of the sinus. A bone grafting mixture is then packed through the pinhole and pushed gently against the membrane using a 3mm Chen sinus condenser. This will slightly raise the sinus, resting it on the newly placed bone.

Once the initial lift in complete, the surgeon switches to a regular sized implant drill and bores through the 2mm conical shape. This opens full access to the sinus cavity. The secondary list introduces more bone graft mixture for the permanent sinus augmentation. The bone grafting material is added until the sinus has been lifted to the proper height for implant placement.

Once a sufficient amount of bone grafting material is condensed under the membrane, the surgeon will place a dental implant by drilling directly into the newly placed bone grafting material, and placing the implant fixture. The crestal incision is then sutured closed.

Complementary Procedures

A dental implant is typically placed at the same time that the Hydraulic Sinus Condensing technique is performed.

Success Rate

Generally speaking this surgery has a very high success rate. Over an 8 year study of 1,557 implants in 1,100 patients using the Hydraulic Sinus Condensing technique, only 8 implants failed, resulting in a 99.99% success rate.

The majority of patients whose implants failed were smokers, or had an abnormally small amount of cortical bone, and in every one of those cases the second attempt at the surgery was successful.

In addition, this procedure allows implant placement with less than 1mm of crestal bone. The sinus is able to be lifted with the presence of a sinus septum or sinus slope, unlike other lift techniques.

Positive Side Effects

Because this procedure fortifies the natural barrier between the sinus and the oral cavities, and can also relieve pressure within the sinus, several patients were referred by Otolaryngologists for this study in an attempt to cure the patients sinusitis. In all such cases the patients reported improvement of their sinus problems, including fewer or no headaches, improved breathing, improved drainage, and elimination of sinus pressure. None of the patients in the study complained of worsened sinus problems, or newly formed sinusitis.

See also

• Sinus Lift Procedure
• Dentistry
• Periodontology
• Oral and maxillofacial surgery
• Bone grafts in dental implantology
• Dental implants
• Osseointegrated implant

References

• "Journal of Periodontology March 2005,". 76 (3): 482–491. doi:10.1902/jop.2005.76.3.482?journalCode=jop. {{cite journal}}: Cite journal requires |journal= (help)

• Chen, Leon, & Cha, Jennifer, (March, 2005). "An 8-Year Retrospective Study: 1,100 Patients Receiving 1,557 Implants using the Minimally Invasive Hydraulic Sinus Condensing Technique". Innovations in Periodontics. 76 (3): 490. {{cite journal}}: Check date values in: |date= (help)CS1 maint: extra punctuation (link) CS1 maint: multiple names: authors list (link)