BackgroundVarious techniques are available for elevating the sinus membrane. The aim of this study is to evaluate three methods of indirect sinus floor elevation regarding elevation heights of 7 mm on the outcomes of membrane perforation, length of perforation, and time required to perform the procedure. MethodsThree different methods for indirect sinus lifting, bone added osteotome sinus floor elevation (BAOSFE), sinus floor elevation with an inflatable balloon, and crestal approach system (CAS kit) from OSSTEM, were assessed for their ability to lift the sinus without causing laceration of the Schneiderian membrane. The study was performed on 18 freshly slaughtered sheep heads (36 sinus lifts were done, 12 for each method). CBCT images of the heads were taken to assess the best location for the sinus lift. Then, the heads were bisected and the membrane was exposed from the medial aspect. After that, each method was performed. The intended elevation height was 7 mm. If the 7 mm were not reached, the maximum height of elevation was measured.ResultsThe method used was significantly associated with the occurrence of perforation (p value = 0.014) where BAOSFE was associated with the largest number of perforations (58.4%, n = 7) compared to 8.3% and 8.3% for the balloon and CAS kit methods, respectively. The odds ratio for perforation occurrence from BAOSFE compared to the CAS kit was significant (OR = 0.091, p = .022). No significant odds ratio was found for the balloon method compared to CAS kit. Additionally, the method used was significantly associated with time of operation and with the length of perforation (p value < 0.001) where CAS kit required the longest time and BAOSFE caused the biggest perforations.ConclusionsThe study shows that both the balloon and the CAS kit were superior to the BAOSFE in terms of safety in elevating the sinus membrane. Further, in vivo studies have to prove these findings.

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An amendment to this paper has been published and can be accessed via the original article.

Objective The aim of this experimental study was to test the possibility of applying internal sinus elevation techniques using controlled hydrodynamic or pneumatic pressure and evaluate their elevation effectiveness. Materials and methods A device was specially designed for this study and was used to elevate the sinus membrane internally in 12 halves of freshly slaughtered sheep heads. The sample was divided into two groups randomly according to the type of controlled pressure applied (hydrodynamic or pneumatic). The elevation height of the membrane was measured in addition to investigating the presence or absence of perforation. Results The maxillary sinus membranes started to be elevated at an average pressure value of 21.6 ± 7.5 millibars (mbar) when hydrodynamic pressure was applied, and at an average pressure value of 23.3 ± 8.1 mbar when pneumatic pressure was applied. The mean values ​​of elevation height after applying the controlled hydrodynamic and pneumatic pressure were 13.00 ± 2.76 and 10.33 ± 3.88 mm, respectively. No perforations occurred in either of the groups. Conclusions The use of a controlled hydrodynamic or pneumatic pressure, which is appropriate for the characteristics of the maxillary sinus membrane in the process of internal elevation, is effective, and it yielded an amount of lifting similar to that we get when using the external elevation.

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