Gel-pressure technique for flapless transcrestal maxillary sinus floor elevation: a preliminary cadaveric study of a new surgical technique.
OBJECTIVE
To evaluate a novel surgical technique for flapless transcrestal elevation of the maxillary sinus floor via surgical templates using gel pressure.


METHODS
Computed tomographic scans of fresh human cadaver maxillae and three-dimensional treatment planning software were used to design surgical templates. Access to the maxillary sinus was gained by guided transcrestal osteotomies to puncture the bony sinus floor. By injection of radiopaque gel, the maxillary sinus membrane was elevated to attain a postoperative bone height of 15 mm.


RESULTS
The gel-pressure technique was performed in 10 atrophic maxillary sites with a mean residual bone height of the alveolar crest of 4.7 +/- 1.6 mm. The sinus membrane was successfully elevated in all sites without causing iatrogenic perforation (mean elevation height, 10.6 +/- 1.6 mm).


CONCLUSIONS
The gel-pressure technique may provide a new option for minimally invasive transcrestal sinus surgery and may represent a safe method to increase bone volume in the atrophic posterior maxilla.
Pommer
Bernhard
B
Deprtment of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Austria. bernhard.pommer@meduniwien.ac.at
Watzek
Georg
G
D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D000543:Alveoloplasty / Q000295:instrumentation / Q000379:methods; D001284:Atrophy; D002102:Cadaver; D003287:Contrast Media / Q000008:administration & dosage; D004867:Equipment Design; D005260:Female; D005782:Gels; D006801:Humans; D065347:Hypromellose Derivatives; D007049:Iatrogenic Disease / Q000517:prevention & control; D021621:Imaging, Three-Dimensional; D007431:Intraoperative Complications / Q000517:prevention & control; D007479:Iopamidol / Q000008:administration & dosage; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008747:Methylcellulose / Q000008:administration & dosage / Q000031:analogs & derivatives; D019060:Minimally Invasive Surgical Procedures; D009092:Mucous Membrane / Q000293:injuries / Q000473:pathology; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D010347:Patient Care Planning; D011312:Pressure; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D055682:Viscoelastic Substances / Q000008:administration & dosage*
D003287:Contrast Media; D005782:Gels; D055682:Viscoelastic Substances; D065347:Hypromellose Derivatives; D008747:Methylcellulose; D007479:Iopamidol