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Densah Sinus Lift utilizing Osseodensification
Posted on 09.12.2015 10:28 PM
By Salah Huwais
In Sinus Augmentation
As promised, I am posting a video detailing the Densah Sinus Lift procedure.
Patient is medically stable. He is missing first and second upper left molars. Bone quality was poor in the second molar position (extraction site with remaining root tip) and ridge width was only 5 mm in area of the first molar. Sinus Pneumatization was evident with sinus floor at 4-6 mm depth.
Four key points to follow:
1- Densah bur to be used sequentially to expand a pilot osteotomy.
2- Densah Burs must not travel more than 3 mm into the sinus beyond the pre-measured sinus floor depth at all times.
3- Densah burs will allow 3 mm lift with autogenous bone graft.
4- If more than 3 mm lift is need, Allograft to be added. In this case, Densah Burs may advance only 0-2 mm beyond the measured sinus floor to gently propel the graft and help create additional lift.
I would like to disclose that I am the inventor of the Densah Bur technology and have a financial interest in Versah, LLC the manufacturer of the Densah Bur.
25 Comments
Maurice Salama says on 09.16.2015 11:42 AM
Excellent video demonstration. These burs seem to work well. Welcome Salah. regards Dr. Salama
Salah Huwais says on 09.16.2015 01:11 PM
Maurice:
Thank you for challenging me to make the video. I apologize for the sound synchronization glitch in it. I hope it demonstrated clearly the simplicity and the flexibility of this procedure. I will post the follow-ups.
armando ponzi says on 09.16.2015 11:53 AM
Dr Huwais,
very interesting innovation. Two questions:
Are densah burs available in Italy?
Are there any dedicated to guided surgery?
Thanks for sharing the interesting video on the technique.
Dr.Armando Ponzi
Salah Huwais says on 09.16.2015 01:26 PM
Armando:
Process is underway for the burs to be officially available in the EU by January 2016.
We are working on guided surgery solution that is universal as well. It will allow for guided surgery without keys. In my hands keys are always a challenge in my guided surgeries so we are trying to simplify the procedure without them. I will keep you posted. Thank you
mia buljan says on 06.08.2016 02:37 AM
Dear Dr. Huwais,
is there anywhere by now distributor for Densah burs in EU? I was trying to find in Italy and Spain, but no results except UK and US.
It is hard to look at such a beautiful cases done with Densah burs and no possibility to try them:) I hope to have them soon.
Thank you,
Mia
Jorge Campos says on 09.17.2015 03:34 PM
Great Video Salah. Another way of using the propeller thrust of the Densa Burs.
Thanks for posting.
See you tomorrow :-)
Jorge
franck Lasry says on 09.18.2015 02:26 PM
If I understand your burs don't lift sinus mucosa ?
And make perforation?
So how do you manage containment of grafting
FL
Salah Huwais says on 09.20.2015 08:56 PM
Franck:
The Burs help in gently lifting the sinus membrane without perforation when they are used according to protocol, which helps containing the graft material.
Salah
Emil DDS says on 09.18.2015 06:06 PM
Salah
Very nice presentation.
I have used this approach successfully numerous times with your burs.
Love them!
Emil
Salah Huwais says on 09.22.2015 07:50 PM
Emil:
Thank you for your confidence in the concept. Your input with others on this forum helping us fine tune the clinical parameters of osseodensification.
Salah
Warren Jones says on 09.19.2015 02:29 PM
Hello Dr. Huwais I have been using these burs for a lot of immediate implant surgeries found it to be very successful with high primary stability for loading. Can these burs be used in single unit implant cases in the posterior mandible where piezo ridge splitting has to be done and is there a need for vertical releasing cuts ?
Salah Huwais says on 09.19.2015 08:27 PM
Warren:
Densah Burs will complement the ridge splitting with peizo. There is no need for vertical release. Just remember you always need 1.8-2.0 mm of bone surrounding your implant. If less than 2mm has resulted from your expansion and placement, then you need to graft. Please review the following post.
http://forum.dentalxp.com/case/details/ridge-expansion-corticotomy-or-khourys-/4762
kevin potocsky says on 09.21.2015 07:53 AM
how would you know if you perf? woulnt see blue membrane and just black hole? and if you do just graft and come back in 3 months?
Salah Huwais says on 09.21.2015 07:13 PM
I usually use a mirror and the Valsalva maneuver to check for any perforations as you saw in the video. If perforation has resulted, it depends on the size of the perforation. I either graft only the socket without pushing any materials into the sinus and achieve primary flap closer and return later for a second attempt or I shift to lateral window approach if the perforation in too large. Either way I do not place the implant if perforation is as wide as the osteotomy. There is an excellent lecture by Michael Toffler on this forum addressing crestal sinus elevation and perforations management. It is a great lecture to see.
Salah
henry salama says on 09.22.2015 10:15 AM
Salah... I really enjoyed your lecture on Osseodensification in Lisbon this past weekend. My compliments... Henry
Salah Huwais says on 09.22.2015 07:47 PM
Henry:
Thank you! Your are a mentor to many out there including myself. I am proud of the fact that you have valued my team work and discoveries. I hope to see you at the AAP this year.
Salah
Benjamin Hanson says on 01.19.2016 09:37 AM
Great video! I have had very predictable results using these burs for doing small lifts and for site preparation for immediates. A true paradigm shift in implant site preparation.
Salah Huwais says on 01.19.2016 12:27 PM
Benjamin:
Thank You! I am proud of my colleagues support. Osseodensification is only a paradigm shift because of pioneers like you, my friend.
I hope to meet you at the XP meeting.
Salah
yiannis vergoullis says on 01.19.2016 10:18 AM
Sarah great video demonstration. The beauty of your invention is that it is simple to implement and requires no additional machinery (piezo). I hope you have great success, you deserve it.
Yiannis
Salah Huwais says on 01.19.2016 12:35 PM
Yiannis:
You are a kind man, Thank you!.
Osseodensification with the Densah Bur will optimize your implant practice. Mark my word. You will do and create more with less.
We are planning a great symposium in 2017 that hinges on how to optimize the site to optimize the outcome. Updates coming soon.
I am always grateful for your support and your trust.
Salah
armando ponzi says on 01.19.2016 12:24 PM
Salah,
once one's got the Versah drill and start using them, your film is much more valuable, as it show some clinical detail to improve the way haptic feed-back works and the surgical course.
Greater video now.
Armando
Salah Huwais says on 01.19.2016 06:19 PM
Armando:
Great, my friend. With the Densah Bur, you will create your own protocols and clinical tricks :)
Salah
Erez NOSRATI says on 11.15.2016 03:07 PM
Have a patient with 3mm bone remaining vertically under the sinus.
Can I use the burs instead of a lateral window?
Charles Schwimer says on 11.15.2016 03:53 PM
Erez. It can be done with Densah burs and I have done with success. The prorocol is more complex than shown in this video. If you need to ask maybe your not prepared yet? Be careful. Regards. Chuck
Erez NOSRATI says on 11.29.2016 11:17 PM
Thanks for your reply. Erez.