An excerpt of an interview with Dr Norton below explains some of the techniques he will demonstrate and how readers can register for this live surgery event – a first in UK dentistry.
What can people expect to learn when they register to view the live sinus lift procedure?
Michael Norton (MN): Before starting the surgery we will look at 3D planning using CBCT, to understand the importance of assessing the morphology of the sinus and presence or absence of pathology.
We will review options for the sinus lift in terms of internal versus external and about the different options for preparing a lateral window, and I will be demonstrating one particular system.
We may review the literature to help gain an understanding that of all the things we do in implant surgery, sinus grafting is one of the few areas where consensus has been demonstrated regarding its efficacy.
What specific technique will you be performing for this surgery?
MN: If you want to be certain that a sinus lift is going to be successful and of value in terms of contributing to bony support around an implant, in my view the best way is with a lateral window – in either a staged, or simultaeous approach.
The 6mm implant is real a game changer, as it does away with the need for internal sinus tents. Based on radiographic assessments alone, one can say with a reasonable degree of confidence that most internal sinus lifts are not actually successful, the membrane is often torn and the graft is ill-confined around the apex of the implant. Of course the implant still osseointegrates with the 4-5mm of basal bone so it is assumed that the graft is successful.
How do you manage the complications often associated with working in the maxillary sinus?
MN: The Schneiderian membrane tear is certainly the most common complication, depending on which studies you read it occurs between 10-40% of the time. I would suggest that this is very much experience dependent – there is no question that one has fewer tears after years of experience.
It has also changed with the advent of new technology. In my early days I would prepare the window using a rosehead bur, which increased the frequency of membrane tears.
Then we moved to piezo surgery, which is still common and something I have worked with in the past, although I find it quite slow. The DASK burs are very quick, perhaps they increase the likelihood of a tear slightly compared to piezo, but with experience the risk is minimised.
To register to view this unique live surgery event and to read the full interview with Dr Norton, please contact the Geistlich regeneration support team. Email: [email protected]/tel: +44 (0) 161 490 2038.