Doug Smail I was out at Spear this past Thursday and Friday Mentoring Level 6a, and I got a lot of questions about Densah sinus bumps.
I have done several hundred of these over the last 3 years, and this method has been the most reliable with the least complications of any I've used.
Honestly, I rarely do lateral wall open sinus lifts anymore because I can make a guide and do these as a one stage with implant placement or a two stage where I graft first and wait.
This is a pretty standard case. I planned the Straumann implant short as we showed at level 6, drilled to the sinus floor, the used the 2.8, 3.5 etc Straumann sleeves to do the sinus bump fully guided. I drill clockwise (forward) direction up to the floor, then hit the switch for counter-clockwise (reverse for densification), and slowly pistoned with a lot of irrigation until I felt the floor give way. I did use some grafting material (Symbios hydrated in PRF) and gently moved it into the bump area using the Densah bur in reverse at 70 rpm. I then placed the implant, which went in at 45+ Ncm.
The last image was at Stage 2, after confirming integration and placing a healing cuff. We went from 4-5mm of bone to 11+mm, in 3 months as compared to 6-9 months for a lateral wall lift.
The other advantage is that I don't need any new kits. I use the burs for normal osteotomies anyway, as they are essentially universal. No osteotomes, no balloons, etc. etc.
Keep It Simple!
