Hydraulic sinus lift technique in future site development: clinical and histomorphometric analysis of human biopsies.

PURPOSE: The fluid-dynamic technique is characterized by the hydraulic detachment of the mucosa and simultaneous filling of the sub-Schneiderian space, with a graft material of paste-like consistency. MATERIALS AND METHODS: Authors performed 13 future site developments, on as many patients (4 men; 9 women; age 49.46 ± 12.44 years), using a nanocrystalline hydroxyapatite dispersed in an aqueous matrix as graft material. In the second stage, performed at 5.96 ± 1.72 months, 13 implants were placed after harvesting bone biopsies from the regenerated sites. The above samples were subjected to histological and histomorphometric analysis. The histomorphometric results were then compared with the bone density, measured in Hounsfield units. RESULTS: The average percentage of vital bone was of 29.08% ± 14.7%, whereas the bone marrow and graft material were 59.75% ± 11.19% and 11.16% ± 10.88%, respectively. The percentage of vital bone has a significant correlation with the bone density of the recipient site (P = 0.003117). In contrast, the bone marrow (P = 0.08692) and the graft (P = 0.0799) do not show a significant correlation with this parameter. CONCLUSIONS: The results suggest the validity of the method in the regeneration of bone volume in the subantral region.

Maxillary sinus floor elevation via crestal approach: the evolution of the hydraulic pressure technique.

The current study describes an innovative protocol for the surgical maxillary sinus augmentation via a crestal approach that uses hydraulic pressure to lift the Schneiderian membrane and simultaneously fill the subantral space with a biomaterial for bone regeneration (nanocrystalline hydroxyapatite in aqueous solution). The technique in question combines the advantages of large amounts of grafted biomaterial with reduced trauma, high precision, and predictability.