Hydrodynamic ultrasonic sinus floor elevation--an experimental study in sheep

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Dental Implantology

Background:

• Sinus floor elevation is a common procedure in dental implantology.
• Traditional methods involve pneumatic or hydraulic pressure, with varying degrees of effectiveness and risk.
• Evaluating alternative methods for sinus membrane elevation is crucial for improving surgical outcomes.

Purpose of the Study:

• To compare the pressure forces required for sinus membrane elevation using hydraulic versus pneumatic techniques.
• To determine the relationship between applied liquid volume, activation time, and achieved sinus lift volume.
• To assess the safety of hydrodynamic ultrasound in elevating the sinus membrane.

Main Methods:

• 190 fresh sheep heads were used for the investigation.
• An ultrasound surgical device (Piezotome) was employed to evaluate pressure increase at different flow rates.
• Elevation volume was measured based on varying flow rates and activation times of the ultrasound device.

Main Results:

• Pneumatic sinus membrane detachment required a mean pressure of 29.54 millibars, while hydraulic technique averaged 19.8 millibars.
• A flow rate of 60 mL/minute resulted in an elevated volume of 0.52 mL.
• A 20-second activation time yielded an average lifted volume of 3.92 mL, increasing to 5.58 mL at maximum flow.
• A significant correlation (P = .03) was found between application time and created sinus lift volume.
• No sinus membrane ruptures occurred in 190 experiments, even at high flow rates (60 mL/minute) for 20 seconds.

Conclusions:

• Hydrodynamic ultrasound presents a viable alternative for sinus floor elevations of various sizes and volumes.
• The transcrestal approach using this method requires only a 3-mm diameter.
• Further clinical investigations are recommended to validate these findings from the animal study.