Crestal Sinus Lift using Versah Drills?

My understanding is Versah does not work well with xenograft. I hope someone who has more experience with Versah can chime in.

Use the protocol and use allograft mixture to lift the sinus ... it’s been there for a while but if will still work

you have 12 mm of bone you don't have to do a sinus lift. How many have you done?

6 mm is enough to place an implant that is designed for weak bone with agressive threads and nanorough surface. I won't mention the brand. No need for sinuslift. With a cheaper implant 8 mm is enough but probably longer healing time than 6 weeks. With less than 8 you could do a sinuslift with concave drills like Meisinger has, for example, that work well in my experience. You can use concave osteotomes+ bone graft as described in Summers' technique. I' ve had several tears in the sinus membrane doing this so I abandoned the technique. Another thing to consider is that patiënt probably has chronic sinusitis, to tell by the thickness of the lateral antral wall. No grafting in infected sinuses. By the way Osseodensification does not result in better bone contact, on the contrary. Primary stability can improve but secondary is less. I also bought lots of gadgets in the past but the only one that sticks is the Meisinger drill kit. Hope my experience helps.

Seems logical that the non (or very slow) resorption of xenograft impregnated bone affects the later densification. As mentioned a good reason to use fully resorbing materials - doesn’t need to be allograft. A latest generation synthetic like silicate substituted BTCP will work well - especially in putty form. Another option is to utilise an implant specific to the safer sinus protocol like the DIVA, which gently elevates the lining and allows flowable graft placement THROUGH its lumen. Regards Robert

That is an unusual case? It's hard to tell from the radiographs, but it looks like the MB and DB roots were removed from the first molars? If that is the case, your osteotomy will be through the middle of the tooth and should have little contact with the possible xenograft that was placed. You will be mostly pushing autogenous bone plus any allograft you add into the floor of the sinus with the Densah burs. I don't see a problem there and they are much safer to control than osteotomes in my hands. I also do not see any inflammation of the sinus per other comments. You should have no problem placing a 5 x 10-11mm implant in that site.