Use of hydrodynamic grafts in crestal sinus lift

Sinus lift procedures are safe and well documented regenerative procedures. Crestal approach is an effective procedure that can be used in the great majority of the cases of insufficient bone availability in the poster maxilla area. Different grafts can be used but xenograft show good results and effectiveness.

Crestal approach shows reduced morbidity and lower surgical difficulties if compared to lateral approach. However, the selection of the procedure is based on anatomic parameters and not only related to personal skills. In particular crestal approaches are more indicated in anatomically narrow sinuses rather than in wide ones. Particulate xenografts are widely used for crestal sinus lift, but “gel form” grafts (hydrodynamic grafts) are extremely useful and easy to use for elevating Schneider’s membrane during crestal approach exploiting the capability of gel form in safely and quickly detaching the membrane. In particular gel grafts works perfectly if used in 1-stage approach (implant inserted contextually to crestal sinus lift) because the implant acts as “tenting screw”. In case of crestal 2-stage approach (delayed implant insertion) probably the best solution is to elevate the Schneider’s membrane adding particulate graft after the hydrodynamic gel graft, to increase the consistence of the regenerative material.