Hydraulic Sinus Condensing Technique: Interview with Dr. Leon Chen
Developed by Dr. Leon Chen, Hydraulic Sinus Condensing, has allowed dental implants to be placed in cases where as little as 2mm of bone was initially present. This technique is less invasive than other sinus augmentation methods and easier to perform on severely sloping sinus floors or with presence of septum.
Osseonews (ON): What is your view on managing a clinical situation where the patient is treatment planned for implants in the posterior maxilla where the maxillary sinus is low or has pnuematicized?
Dr. Chen: This is a very common, but difficult situation. Ideally we want to place the implants where the restoring doctor needs them and not simply where there is adequate bone height and volume. This situation is best managed with a sinus lift and bone graft.
ON: There are many surgical techniques for accomplishing this. We understand that you have developed a very simple and straightforward technique for this.
Dr. Chen: I was dissatisfied with the current surgical techniques because they were cumbersome and involved more invasive interventions than are really needed. The technique I developed is far less invasive and has a much lower incidence of morbidity and complications.
ON: Could you describe the hydraulic sinus condensing technique.
Dr. Chen: I drill a small hole in the crest of the alveolar ridge and deliver a steam of water under hydraulic pressure. This loosens the sinus membrane. I then make a small window on the lateral crest and condense bone graft material mixed with plasma rich protein under the loosened sinus membrane. As I continue to graft and condense more bone the sinus membrane is elevated and supported by the graft.
ON: How do you deliver the stream of water?
Dr. Chen: Right now I am using the handpiece for that.
ON: How much bone can you graft?
Dr. Chen: I can gain 10-15mm of vertical bone height.
ON: Can you extract teeth, graft the sockets and elevate and graft the sinus in the same visit.
Dr. Chen: Yes and this is the way I actually prefer to do this.
ON: After the grafting has been completed do you then lay a flap for implant placement?
Dr. Chen: Well you can do that. But I have found that after I have finished grafting, the implants can be placed using a flapless procedure. Again this contributes to reducing the incidence of morbidity and complications. This is a much better situation for the patient.
ON: How do you manage a situation where a septum is present in the graft area?
Dr. Chen: The location of a septum is not significant. It does not affect the procedure.
ON: What about the morphology or slope of the maxillary sinus floor?
Dr. Chen: Again this is not significant. The membrane is loosened and elevated and the condensation of the bone graft adapts to the slope and configuration of the sinus floor.
ON: How comfortable are your patients after this procedure?
Dr. Chen: Most return to work the same day. Complications are minimal.
ON: How many cases have you treated using this technique?
Dr. Chen: Over two thousand during the last ten years.
Dr. Leon Chen is a fellow and diplomate of The International Congress of Oral Implantologists. Dr. Chen is also a main podium speaker for The Academy of Periodontology, The International Implant Symposium, The International Congress of Oral Implantologists, and The European Federation of Periodontology. Dr. Chen was nominated to participate in the advisory board of scientific council in the German and Italian journal of Implantology and Paradontology. He is also an editor for The International Magazine for Oral Implantology, and the medical advisor for LV Health. As a published author he has lectured extensively on dental implants and cosmetic soft tissue grafts both nationally and internationally. Find out more at: www.diilv.com/
Interview provided by Dr. Gary Kaplowitz, Special Editor for OsseoNews.com
