title: Schneiderian membrane detachment using transcrestal hydrodynamic ultrasonic cavitational sinus lift: a human cadaver head study and histologic analysis.
abstract: OBJECTIVE
  Recent studies have suggested the osteogenic layer of the periosteum at the base of the sinus membrane to play a key role in bone regeneration after sinus lift procedures. Thus, atraumatic detachment of the sinus membrane with an intact periosteum seems mandatory. The present histologic study of fresh human cadaver heads investigated the detachment behavior and histologic integrity of the detached periosteum after application of the transcrestal hydrodynamic ultrasonic cavitational sinus lift (tHUCSL-INTRALIFT).
  
  
  METHODS
  A total of 15 sinuses in 8 fresh human cadaver heads were treated using tHUCSL-INTRALIFT. After surgery, they were checked macroscopically for damage to the sinus membrane and then processed for histologic inspection under light microscopy. A total of 150 histologic specimens, randomly selected from the core surgical sites, were investigated using hematoxylin-eosin (HE), Azan, and trichrome staining.
  
  
  RESULTS
  None of the 150 inspected specimens showed any perforation or dissection of the periosteum from the subepithelial connective tissue and respiratory epithelium and were fully detached from the bony antrum floor. The connecting Sharpey fibers revealed to be cleanly separated from the sinus floor in all specimens.
  
  
  CONCLUSIONS
  The results of the present study suggest tHUCSL-INTRALIFT should be used to perform predictable and safe detachment of the periosteum from the bony sinus floor as a prerequisite for undisturbed and successful physiologic subantral bone regeneration.
authors.affiliation: Senior Attending Surgeon, Department of Maxillofacial Surgery, General Hospital "Hietzing" of the City of Vienna, Vienna, Austria. Electronic address: troed@aon.at.
authors.forename: Angelo
authors.initials: A
authors.lastname: Troedhan
authors.affiliation: Department Head, Implantology Clinic Oberkassel, Dusseldorf, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kurrek
authors.affiliation: Department Head, Implantology Clinic Kaiserswerth, Dusseldorf, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Wainwright
authors.affiliation: Associate Professor, Department of Cranio-, Oral-, and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Jank
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods; D002102:Cadaver; D006801:Humans; D057446:Hydrodynamics; D009297:Nasal Mucosa / Q000473:pathology / Q000601:surgery*; D014465:Ultrasonics