I'm dr. Alex Yeh and today we are going to talk about crustal approach sinus lift procedures
and surgical implant placements. today you will see a live surgery performed by dr. Benjamin Jin
on his identical twin brother dr. Alva Chinn the crustal approach sinus lift differs from
the lateral approach sinus lift in that it is considered less invasive however it is limited
to certain cases and case selection is important the surgical kit we will be using is the high
Olson casts kit this is short for Prestel approach sinus kit this includes drills
which create an osteotomy site but avoids cutting the sinus membrane this is an
important aspect of this particular kit as well as the use of hydraulic pressure
to safely lift the sinus membrane vertically to allow for bone graft and implant placement
we are going to get started with dr. Ben and dr. Alva introducing themselves so my name is
dr. Benjamin Jen we're gonna be doing a crystal approach to sinus lift today and we're going
to be placing two implants in so my patient is actually my brother he's a his name's dr. Alva
Chinn so you'll be seeing both of us at smiles dental group okay it's a little nerve-wracking
but we have excellent equipment here comb beam CTS with guided surgery so it really
takes the stress off hi my name is a doctor a legend I'll be getting a sinus lift and also
two implants placed by my brother I'm very confident because my brothers are excellent
dentists and he has great equipment here at small dental okay so this is the these are some of the
drills that we're gonna be using dr. Ben is uh freezing his brother and taking some photos
that Shania one of our dental assistants we're gonna finish counting up here this
is shot at our Spruce Grove clinic right now dr. Ben is making his initial incision along
the crest of the maxilla and the indenture l'espace its teeth number two six and two
seven that are missing nice clean incision so here the the flap has been released and
we can see the full crest of the bone the alveolar bone that is the surgical
stent that dr. Ben's going to be using it was created with the help of our CB CT
is very stable because it fits exactly on dr. Alva's teeth and helps ensure that the
angle and adaptive placements are exactly as we planned them to be and minimizes the risk
of perforation or mal placement of the implants so right now we're creating the osteotomy site
just short of the sinus membrane sinus floor and now without the surgical guide he's using
dr. Bennett's using the personal approach sinus lift kit by iesson and so now he's
he's lifting the floor safely with this instrument to Hanna Schmidt and now we're hydraulic using
hydraulic pressure saline to lift to slowly and gently lift the sinus membrane so you can
you can actually measure the volume of saline that you're pushing into the sinus and then
retracting out here we're mixing the ball in with saline this is a bone graft material I believe is
cortical cancellous bone grafting material and we use a little syringe to deliver the the bone
into the into the site you can see the syringe right there and so he's just pushing the bone
graft achill into the Austra osteotomy site and then manually pushing it with a condenser into
the sinus space but below the sinus membrane because again the science membrane has not
been perforated so just carefully delivering the bone into the sinus under the membrane
I'm just condensing it in
this is so we're just taking an interim CBC tea just to make sure everything is looking
good which it is so we're ready now to place the implants in the exact osteotomies site as as we
used for the sinus lift and bone graft so this is what makes this minimally invasive because
the same holes that we used to deliver the bone and lift the membrane they are the holes or the
osteotomy site that we're using to place the implants this is in contrast to the flowers
both sides lifting the bone graft where you have two separate surgical sites one could
be lifting bone graft and then a separate site for the implant placement so you can
see you can see that the implants are being torqued in initially with the handpiece and
then secondarily with the torque wrench this I believe are we're using straumann implants in
this particular case although we routinely use high Osen as well as Nobel implants
so we're talking it's I believe dr. Ben's torquing it to about fifty fifty or so Newton centimeters
50 to 70 Newton centimeters I think so this is the second implant that he's placing in the exact same
manner it's 35 that's yeah it looks as though is talking to about 50 or 60 Newton centimeters
everything's looking good patience is comfortable not feeling anything no
pain this is done under local anesthesia only so again only the site is frozen
the patient dr. Alva is not sedated very comfortable the procedure is going really
well and it's it's not taking much time so so the patient's not really uncomfortable
switching some photos for dr. Ben's
collection his gallery so you can see the the flap has been nicely released and now
the healing abutments are in place those those are those caps that are on top of the implants
there those are helium but mints the implants are placed at the level of low bone Horstman
potentially slightly below here's a bone level implants that he's placing and you
can see they're quite parallel and the spacing is fairly ideal and so now we're just suturing
the the osteotomy site just closing up the closing up the surgical site it's placing a
few interrupted sutures and we're taking another CBC tee with dr. Alva and we're gonna see the
implant and bone grafts with sinus lifts so you can see there's quite a bit of lift we've got
quite a bit of lift and balinese see there's probably about there's more than what's what
was needed but everything looks good from the x-rays everything look really good a
little tired from the procedure cuz there was a lot of work but everything was done
very professionally I was in good hands so the procedure is completed everything went exactly
according plan further is an excellent patient we checked the x-rays and everything went exactly
where it's supposed to be sinus lift looks great and I'm sure he's gonna be a very happy patient
so that was the crustal approach sinus lift and implant placements live surgery with dr.
Ben and dr. Alva Chinn if you have any questions feel free to give us a shout or email us at our
website smiles and lucam that's wwl Dental Group comm and if you do have interest in dentistry
or dental procedures please I encourage you to subscribe to our YouTube channel