Sinus Graft

3mm Buccal Osteotomy | Hydraulically Lift the Membrane

Hydraulically Lifts the Sinus Membrane via a 3mm Buccal Osteotomy

Sinus lift surgery has become more common as patients choose implants for tooth replacement. The unique characteristics of Sinus Graft has allowed for refinement of this surgical modality to a degree that allows practitioners to provide a previously unattainable level of care for their patients.

The Steiner Sinus Lift:
The Next Level in Surgical Procedure

In adults, the size of the maxillary sinus often needs to be reduced to permit tooth replacement with dental implants. However, the cost, morbidity, and surgical complexity associated with maxillary bone augmentation has limited the use of this procedure. The Steiner Sinus Lift addresses each of these issues with the intention of making maxillary bone augmentation in the floor of the sinus a simple, non-traumatic procedure within the skill level of all dental practitioners.

For further information on the Steiner Sinus Lift, please review our article titled “Minimally Invasive Sinus Augmentation” published in the Journal of Oral Implantology.

Minimally Invasive Sinus Augmentation with Sinus Membrane Removal

It is known that the sinus membrane does not contribute to bone production during sinus augmentation procedures. However, it is assumed that the membrane is required to contain the sinus graft material for successful sinus augmentation procedures. Like so many assumptions about bone, this is another false assumption. The sinus membrane is not needed for predictable successful sinus augmentation with same day implant placement.

The simplicity of this methodology reduces the level of skill required to perform predictable sinus augmentation, shortens the time required to perform the surgery, and significantly reduces post-op morbidity. The time between grafting and implant placement and restoration is dependent on the amount of residual crestal bone, but in most cases the implants can be restored in 3 months.

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.

Sinus Graft

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

Sinus Graft

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

Sinus Graft

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.

Sinus Graft

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

SL Factor is time released as Sinus Graft is degraded. SL Factor enters into 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.

“Modern beta tricalcium phosphate bone grafts perform as well or better than allografts or autografts. The negatives of autograft morbidity and cadaver harvesting makes high performing βTCP a superior choice.”


American Society for Bone and Mineral Research (ASBMR)

Tissue Engineering and Regenerative Medicine International Society (TERMIS)