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Lateral Sinus Elevation

In this surgical procedure, Professor Hannes Wachtel, Munich/Germany, performs a lateral sinus augmentation and an augmentation of the alveolar ridge, demonstrating how specific sinus augmentation instruments can be used to mobilize Schneider's membrane without causing damage.

The surgeon is demonstrating and explaining individual surgical steps required for a successful lateral sinus augmentation. The implantation is performed in a second surgical procedure (not part of this video). After the primary incisions and careful flap preparation the alveolar bone becomes accessible. Since the visible alveolar ridge is too slim for an implant placement a simultaneous extension of the alveolar ridge needs to be achieved. Once the bone defect is clearly exposed, remaining granulation tissue and pins stemming from a former unsuccessful procedure are removed.

Now, the access window for the lateral sinus augmentation is prepared using rotating instruments – carefully to preserve the sinus membrane (Schneider membrane). The membrane is lifted from its underlying bone including the area of the medial maxillary sinus wall. This step has to be performed with great caution in order to avoid any ripping and perforation of the sinus membrane. Sharp bone edges along the window have to be removed. In order to provoke little bleeding spots the cortical substance of the bone is perforated. An absorbable bone substitute is then gently inserted between the mobilized membrane and the maxillary sinus wall and floor.

The bone substitute material is expected to be gradually absorbed and replaced by newly formatted bone over time. As part of the horizontal alveolar ridge extension procedure, a membrane that functions as a long-lasting barrier is fitted and inserted. The same absorbable augmentation material as before is used as a “space keeper” to extend the alveolar ridge towards the buccal area. Covering the bone substitute the membrane is fixed using titanium pins. Finally, the flaps need to be replaced tension free.

Secure wound closure with a multi-layer suturing technique facilitates primary wound healing and completes the lateral sinus and horizontal alveolar ridge augmentation procedure.

Lateral Sinus Elevation

In this surgical procedure, Professor Hannes Wachtel, Munich/Germany, performs a lateral sinus augmentation and an augmentation of the alveolar ridge, demonstrating how specific sinus augmentation instruments can be used to mobilize Schneider's membrane without causing damage.

The surgeon is demonstrating and explaining individual surgical steps required for a successful lateral sinus augmentation. The implantation is performed in a second surgical procedure (not part of this video). After the primary incisions and careful flap preparation the alveolar bone becomes accessible. Since the visible alveolar ridge is too slim for an implant placement a simultaneous extension of the alveolar ridge needs to be achieved. Once the bone defect is clearly exposed, remaining granulation tissue and pins stemming from a former unsuccessful procedure are removed.

Now, the access window for the lateral sinus augmentation is prepared using rotating instruments – carefully to preserve the sinus membrane (Schneider membrane). The membrane is lifted from its underlying bone including the area of the medial maxillary sinus wall. This step has to be performed with great caution in order to avoid any ripping and perforation of the sinus membrane. Sharp bone edges along the window have to be removed. In order to provoke little bleeding spots the cortical substance of the bone is perforated. An absorbable bone substitute is then gently inserted between the mobilized membrane and the maxillary sinus wall and floor.

The bone substitute material is expected to be gradually absorbed and replaced by newly formatted bone over time. As part of the horizontal alveolar ridge extension procedure, a membrane that functions as a long-lasting barrier is fitted and inserted. The same absorbable augmentation material as before is used as a “space keeper” to extend the alveolar ridge towards the buccal area. Covering the bone substitute the membrane is fixed using titanium pins. Finally, the flaps need to be replaced tension free.

Secure wound closure with a multi-layer suturing technique facilitates primary wound healing and completes the lateral sinus and horizontal alveolar ridge augmentation procedure.

About the expert

Hannes Wachtel

Prof. Dr. Hannes Wachtel

Specialist for periodontology at the Bolz/Wachtel Dental Clinic

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