No abstract

The implant-supported prosthetic rehabilitation of the posterior maxilla may require sinus-grafting procedures due to poor quality and low volume of bone. This can be accomplished using a "lateral window" sinus augmentation or with an osteotome sinus floor elevation (OSFE). The hydrodynamic ultrasonic cavitational sinus lift (HUCSL) (Intralift) is derived from the osteotome technique and allows the reduction of some of the traumatic effects of the osteotome technique. The aim of this study was to compare OSFE and the HUCSL procedures on fresh human cadaver heads. Primary outcomes were the height and width of the grafting area in the sinus floor area. Eighty-four maxillary sinuses were selected. On each fresh cadaver head, 2 sinus lifts were done using OSFE and HUCSL in the maxillary sinuses. Computerized tomography scans were performed on each head before and after the surgeries. Measurements were done on radiologic pictures using dedicated software, and the integrity of the sinus membrane was observed after dissecting the maxillae. The use of HUCSL resulted in a significantly higher sinus floor augmentation in the mesio-distal and bucco-palatal direction compared with the osteotome technique (P < .001). There was no correlation between mesio-distal and bucco-palatal diameters of sinus floor augmentation when only the osteotome protocol was considered (r = 0.27 and P = .08). In contrast, the mesio-distal and bucco-palatal diameters of floor augmentation were correlated when the HUCSL protocol was considered (r = 0.79, P < .001). HUCSL represents a good alternative method for sinus floor elevation.

A 42-year-old woman had sustained a severe dental trauma with an alveolar fracture after an epileptic attack. A tooth block 31, 32, 33 and 34 was dislocated about 7 mm in buccal direction. Panoramic X-rays and CT-scan disclosed the alveolar fracture without total disjunction of the fragment. An orthodontic appliance was used to reduce the fracture with gentle forces during a 5-month period. Normal function was established and the teeth remained vital.