SINUS GRAFT™

Steiner Sinus Lift- 3mm buccal osteotomy, hydraulically lift the membrane, place the implant at time of graft, load implant 3 months later.

Ridge And Sinus Augmentation

View 47 consecutive sinus augmentation cases

Minimally Invasive Sinus Augmentation Guidelines

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Steiner Sinus Bump Technique

Patented to Stimulate Osteogenesis

Specifically designed for Hydraulically Raising the Maxillary Sinus Membrane for Sinus Augmentation.

 

Turning the switch ON to osteogenesis

SINUS GRAFT™ is a Trade Mark of Steiner Biotechnology.  Sinus Graft™ has enabled the creation of new surgical procedures, such as the Steiner Sinus Lift, which allows practitioners to provide a previously unattainable level of care for their patients.

SINUS GRAFT™ bonds to the sinus bone and the implant surface. As osteoblasts migrate through the graft they reach an implant surface and produce implant integration. In this manner implants can be placed at the same time as grafting with the confidence that complete implant integration will occur.

The tissue engineering of bone requires the biologic stimulation of host cells. Due to the short half life of growth factors when placed in the graft site and the inability of a single growth factor to orchestrate the complex temporal and spatial molecular reactions needed to produce tissue, the use of single growth factors for the biologic stimulation of host cells produces only limited bone growth. For these reasons, Sinus Graft ™ does not use growth factors, but instead contains SL Factor which stimulates the cell to increase the production of growth factors and other signaling molecules. SL Factor is time released as Sinus Graft ™ is degraded. SL Factor enters the osteoblast and stimulates the osteoblast to produce the required signaling molecules and growth factors for bone production. SL Factor is transported across the cell membrane and into the nucleus, where it has been shown to stimulate the activity of over 300 genes and to produce an up-regulation in genes known to stimulate bone formation and a down-regulation in genes that facilitate bone loss. SL Factor stimulates mesenchymal stem cells to differentiate into osteoblasts and increases the production of alkaline phosphatase. SL Factor creates a two-fold increase in BMP2 and Runx2 production and reduces osteoclast formation by inhibiting the production of RANK ligand. In addition, SL Factor is stored in the osteoblast and continues to stimulate bone growth after the synthetic matrix has been resorbed.

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SINUS GRAFT™ AND THE STEINER SINUS LIFT

A crestal incision is made to expose the buccal maxilla. Radiographs are used to locate the floor of the sinus and a #10 round burr perforates the lateral wall of the sinus.

O-Osteoid-like bone lining, M- sinus membrane, B- bone The micropaddle is approximately 1mm in diameter.

The osteotomy is commonly 2-3 mm deep and 3-4 mm is diameter to reach the sinus membrane. A 1mm micropaddle (Steiner Laboratories) is pressed onto the osteoid-like layer or the sinus membrane and slipped between the membrane and bone. The micropaddle is used to separate the membrane from bone for about 5 millimeters around the osteotomy.

After the membrane has been released from around the osteotomy a micro-ball is used to further release the membrane mesial and distal to the osteotomy and to separate the membrane from the floor of the sinus and across to the medial wall of the sinus. As long as the micropaddle and the microball stay in contact with bone the membrane will not be damaged.

The syringe tip of SINUS GRAFT™ is placed in the osteotomy. As the graft material is injected the sinus raises under hydraulic pressure. The amount of sinus lift is determined by the amount of graft material injected.

This patient presented with severe disease requiring the removal of teeth #3 and 4.

After removal of the teeth and healing the patient presents for sinus augmentation.

The osteotomy is completed and 2 cc’s of SINUS GRAFT™ is injected according to the above methodology. Noting a symmetrical rise of the sinus membrane the sinus is ready for completion of the grafting procedure.

With the addition of a total of 6 cc’s of SINUS GRAFT™ The floor of the sinus is filled with graft material and adequate elevation of the membrane has occurred to allow normal length implants to be placed.

The osteotomies are prepared after the graft has been placed. The graft material will begin to set so the osteotomy drills must penetrate the full length of the planned implant.

The implants are in place the day of surgery.

Two week post op after grafting with SINUS GRAFT™. It should be noted that the sinus membrane will raise with hydraulic pressure as a dome. As a result a few millimeters extra height of the membrane is suggested to ensure the implant is within the arch of the dome.

For further information on the Steiner Sinus Lift please review our article titled “Minimally Invasive Sinus Augmentation” published in the Journal of Oral Implantology available under our publications tab at the top of the page.

 

SINUS GRAFT™ & THE STEINER SINUS LIFT™

This patient presented with caries, periodontal disease and endodontic pathology on tooth #14.

Tooth #14 was removed and grafted with Socket Graft Putty. 8 weeks after extraction and grafting the patient presented for implant placement.

The implant osteotomy was prepared and the floor of the sinus was perforated without damaging the sinus membrane. SINUS GRAFT™ was used to raise the sinus membrane and additional graft material was placed in the implant osteotomy prior to implant placement.

The implant is placed with the sinus membrane elevated in the area of the implant.