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Posted on By Rodrigo Neiva In Sinus Augmentation

I showed this case during my last webinar but I realized that I showed it too quickly and did not explain the technique in detail. Here it goes:

Pre-op distance from the alveolar crest to the sinus floor: 8mm; Working length during osseodensification (CCW, reverse more: 7mm; Sinus floor was still intact so I carefully continued my osseodensification to 8mm; Visual and clinical inspection showed that I had entered the sinus cavity without perforation; Continue to use the DENSAH bur in reverse more to push saline solution, and bone into the sinus cavity, creating a hydraulic lift; Confirmed the lift with a PA radiograph; Inserted Novabone Putty into the osteotomy and used the second last DENSAH bur in osseodensification mode (CCW or reverse) at only 50 rpm to push the graft material into the sinus cavity; Repeated this step another 3 times to insert 0.5cc of graft material into the sinus; Placement of a 5.0x11mm Astra OsseoSpeed with 40 Ncm of insertion torque; Implant is currently being restored 8 weeks after placement.

Let me know if you have any additional questions.


Rodrigo Neiva

Pre-op radiograph

Intra-op radiograph

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Rodrigo. Very impressive. How often do you use this approach and what is your criteria for success? What is CCW? thanks Mo


Hi Mo, CCW stands for "counter clockwise" or the burs spinning in reverse mode. I use them at 1200rpm in reverse for osseodensification and 50rpm in reverse to push the putty material into the lifted sinus. I have been using this technique often and my residents here at UF have been doing the same.


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