FACILITATED DENSAH® LIFT PROTOCOL I

 

Minimum residual bone height ≥ 6 mm. Minimum alveolar width needed = 4 mm

Use Densah® Burs in full step increments. For example: 2.0 mm, 3.0 mm, 4.0 mm, 5.0 mm.

• MEASURE BONE HEIGHT TO SINUS FLOOR

• PILOT DRILL 1 MM BELOW THE SINUS FLOOR

• DENSAH® BUR (2.0) IN OD MODE TO SINUS FLOOR

• ENTER WITH DENSAH® BUR (3.0) IN OD MODE UP TO 3MM PAST

THE SINUS FLOOR

• DENSAH® BUR (4.0), (5.0) OD MODE UP TO 3 MM PAST THE SINUS

FLOOR, IF NEEDED

• USE DENSAH® BURS IN FULL STEP INCREMENTS FOR EXAMPLE:

2.0 MM, 3.0 MM, 4.0 MM, 5.0 MM

 

Step 1:

Measure bone height to the sinus foor. Flap the soft tissue using

instruments and technique normally used.

 

Step 2:

Pilot drill 1 mm below the sinus foor. In cases where posterior residual

alveolar ridge height is ≥ 6.0 mm, and additional vertical depth is desired, drill to the depth determined within an approximate safety zone of 1.0 mm from the sinus _oor using a pilot drill (clockwise drill speed

800-1500 rpm with copious irrigation). Confirm pilot drill position with a

radiograph.

 

Step 3:

Densah® Bur (2.0) OD mode to sinus floor. Depending upon the implant

type and diameter selected for the site, begin with the narrowest

Densah® Bur (2.0). Change the surgical motor to reverse-Densifying

Mode (counterclockwise drill speed 800-1500 rpm with copious

irrigation). Begin running the bur into the osteotomy. When feeling the

haptic feedback of the bur reaching the dense sinus floor, stop and

confirm the first Densah® Bur vertical position with a radiograph.

 

Step 4:

Enter with Densah® Bur (3.0) OD mode up to 3 mm past the sinus floor. Use the next wider Densah® Bur (3.0) in densifying-mode

(counterclockwise drill speed 800-1500 rpm with copious irrigation) and

advance it into the previously created osteotomy with modulating

pressure and a pumping motion. When feeling the haptic feedback of

the bur reaching the dense sinus floor, modulate pressure with a gentle

pumping motion to advance past the sinus floor in 1 mm increments.

Maximum possible advancement past the sinus 7oor at any stage must not exceed 3 mm. As the next wider Densah® Bur advances in the

osteotomy, additional autogenous bone will be pushed toward the

apical end to achieve additional vertical depth and a maximum

membrane lift of 3.0 mm. Confirm the bur vertical position with a

radiograph.

 

Step 5:

Place Implant. Place the implant into the osteotomy. If using the

surgical motor to tap the implant into place, the unit may stop when

reaching the placement torque maximum. Finish placing the implant to

depth with a torque indication ratchet wrench.


FACILITATED DENSAH® LIFT PROTOCOL II

 

Minimum residual bone height 4-5 mm. Minimum alveolar width needed = 5 mm

Use Densah® Burs in full step increments. For example: 2.0 mm, 3.0 mm, 4.0 mm, 5.0 mm.

 

• MEASURE BONE HEIGHT TO SINUS FLOOR

• AVOID USING A PILOT DRILL

• DENSAH® BUR (2.0) OD MODE TO SINUS FLOOR

• ENTER WITH DENSAH® BUR (3.0) OD MODE UP TO 3 MM PAST THE SINUS FLOOR

• DENSAH® BUR (4.0), (5.0) OD MODE UP TO 3 MM PAST THE SINUS FLOOR TO FURTHER EXPAND THE OSTEOTOMY

• USE DENSAH® BURS IN FULL STEP INCREMENTS FOR EXAMPLE: 2.0 MM, 3.0 MM, 4.0 MM, 5.0 MM

• USE THE LAST DENSAH® BUR IN LOW SPEED TO GENTLY PROPEL WELL HYDRATED ALLOGRAFT

 

 

Step 1:

Measure bone height to sinus floor. Flap the soft tissue using instruments and technique normally used.

 

Step 2:

Densah® Bur (2.0) OD Mode to sinus floor. Avoid using a pilot drill. Depending upon the implant type and diameter selected for the site, begin with the narrowest Densah® Bur (2.0). Change the surgical motor to reverse (counterclockwise drill speed 800-1500 rpm–Densifying Mode with copious irrigation). Begin running the bur into the osteotomy until reaching the dense sinus floor. Confirm Bur position with a radiograph.c

 

Step 3:

Enter with Densah® Bur (3.0) OD mode up to 3 mm past the sinus floor.

Use the next wider Densah® Bur (3.0) and advance it into the previously created osteotomy with modulating pressure and a pumping motion. When feeling the haptic feedback of the bur reaching the dense sinus floor, modulate pressure with a pumping motion to advance past the sinus floor in 1 mm increments, up to 3 mm. Maximum bur advancement past the sinus floor, at any stage, must not exceed 3 mm. Bone will be pushed toward the apical end and will begin to gently lift the membrane and autograft compacted bone up to 3 mm. Confirm the bur vertical position with a radiograph.

 

Step 4:

Densah Bur (4.0), (5.0) OD mode up to 3 mm past the sinus floor. Use the sequential wider Densah® Burs in Densifying Mode (Counterclockwise drill speed 800-1500 rpm) with copious irrigation with pumping motion to achieve additional width with maximum membrane lift of 3 mm (in 1 mm increments) to reach final desired width for implant placement. Densah® Burs must not advance more than 3 mm past the sinus floor at all times regardless of the Densah® Bur diameter.

 

Step 5:

Propel allograft.

After achieving the final planned osteotomy diameter, fill the osteotomy with a well hydrated, mainly cancellous, allograft. Use the last Densah® Bur used in step 4 in Densifying Mode (Counterclockwise) with low speed 150-200 rpm with no irrigation to propel the allograft into the sinus. The Densah® Bur must only facilitate the allograft material compaction to further lift the sinus membrane, and not to advance beyond the sinus floor more than 2-3 mm. Repeat the graft propelling step to facilitate additional membrane lift as needed according to implant length.

 

Step 6:

Place implant.

Place the implant into the osteotomy. If using the surgical motor to tap the implant into place, the unit may stop when reaching the placement torque maximum. Finish placing the implant to depth with a torque indicating wrench.


* Data on file, visit versah.com/our-science/ for Maxillary Sinus Graft studies

Clinician judgement and experience should be applied in conjunction with this suggestive use protocol.

 

10517 REV04 updated: 10/2022