SIMPLELIFT® SINUS ELEVATION KIT

No Nonsence Drill-Less Crestal Lift Kit

We have ended the confusion of having to choose specific tool length and diameter among dozen of instruments in a box. The five tools in the Simplelift® Kit creates the perfect length and width for two implants sizes that are most suitable for placements in the posterior maxillary area. the system takes into consideration the bone consistency and the minimum height of bone needed for implants used imposter maxillary area.

INSTRUCTIONS FOR USE

Introduction:
This kit was created to simply and reliably perform a sinus elevation procedure with minimum chance of membrane rupture while condensing the soft posterior maxillary bone to stabilize the implant in as little as 2 mm of bone height.
The tools are pre-measured for use with Implanova® self-grafting implant diameters of 4.5 or 5.5 in lengths of 8 and 10 mm: 4.5 X 10 mm, 4.5 X 8 mm, 5.5 X10 mm and 5.5 X 8 mm

Indications:

  1. A sinus lift or sinus elevation or sinus bump is indicated when there is less than 10 -12 mm of bone available from the alveolar crest to the floor of the sinus.
  2. When used with Implanova ® self-grafting bone-level implants, this kit can be safely used to engage an implant with adequate primary stability in as little as 2 mm of bone in sinus floor.
  3. When used with Implanova® self-grafting bone-level implants, this kit can be used in furca of immediately extracted molar with minimum bone thickness of 1 mm.

Armamentaria:

  1. SimpleLift® kit
  2. Surgical mallet
  3. High-speed or surgical handpiece with #8 round bur
  4. Implanova® 4.5X10 or 4.5X 8 or 5.5 X10 or 5.5 X 8 implants
  5. Implant placement tools
  6. Any type of bone graft material

IMPORTANT: Use of magnification and head-mounted illumination is absolutely essential for reliable and successful sinus lift procedure.

1-Right and Left Punch

Each punch tool consists of a semilunar chisel and a bumper. While the sharp chisel cuts through the last mm of sinus floor, the bumper prevents the chisel to run into the sinus cavity. The right and left punch are used alternatively and by rotating 180 degrees to create a clean circular cut into the sinus floor with minimum chance of rupturing the sinus lining membrane.

 

2-Spreader

It is a rounded tool to help in gently separating the membrane from cortical bone and/ or to spread the bone graft material circumferentially.
Very gentle hand pressure is used to manipulate the spreader.

Caution: The spreader must not be inserted directly in the osteotomy. The head of the spreader must be rested against the side of osteotomy wall and gently and slowly worked in, until the head drops into the sinus cavity while the stem is resting against the osteotomy wall. At this point, the stem is laterally moved against the osteotomy wall, while the head is creating the separation and elevation of the membrane in preparation of the implant. Avoid any vertical pressure on the spreader because it will likely result in rupture of the membrane.

3- Standard and Wide Dilators

Dilators are based on the principle that the bone in posterior maxillary region is often very soft and spongy. Therefore, osteotomies that are performed by rotary instruments often do not provide adequate primary stability for implant integration. Dilators enlarge the initial osteotomy to receive a 4.5 mm diameter or a 5.5 mm diameter implant by condensing the spongy bone laterally. A twirling hand motion or a mallet or a combination of the two is used on the dilators.

For diameter 4.5mm

For diameter 5.5mm

Step by step procedure

1. Initial osteotomy:
a. If the area is edentulous and radiograph shows 5 mm or less thickness of sinus floor: Use a #8 round bur to create a 3 mm wide circular hole to remove bone till you reach 1 mm crestal to the membrane.

When you reach close to the membrane and look with magnification and illumination, you can often see a “bluish” color shining through. This is the 3mm ditch.

b. If the area is edentulous and there is more than 5 mm of radiographic bone at the sinus floor:
Continue the osteotomy from the ditch with a cylindrical twist drill about 3 mm in diameter, preferably with a drill stopper until 1 mm short of the sinus floor.

c. If it is a fresh extraction site, place a round bur , preferably in high speed at the furcation area to create your 3 mm ditch.

2. Relieving the floor of sinus:

Use the right and left punches alternatively to cut a circle around the osteotomy. The assistant with the mallet, must proceed cautiously towards the end as to not push the punch in the sinus. Each punch will do half circle in 3 steps.

Most likely, if your calculations have been accurate, by the time you use the second punch in 3 different positions, you should “feel” the bony floor relieved.

This is what you like to see upon successful use of the punches:

The island of bone, attached to the membrane, surrounded by a dark circle showing the separation of the island from the floor.

3. Creating space for implant

Use the head of the spreader to gently push the island of bone in until the head drops into the sinus space and while the stem is resting against the wall of osteotomy :

This is how it looks after you created space for the implant .

IMPORTANT : The length of the stem of the Spreader is 12 mm. Of you are planning a 10 mm implant, you can place a layer of collagen against the island as you are continuing to creat space , in order to cushion the forces against the membrane.

If you are planning to place some bone graft, you can insert the material at this stage, before you begin dilating the osteotomy OR after the dilatation of the osteotomy. Use the spreader to place the graft material in the osteotomy.

4. Widening and condensing the osteotomy.

Place the tip of the medium dilator in the osteotomy and press in.

Use twirling motion to drive the entire dilator in until the stopper ring. If necessary, you can have the dilator tapped in with the malet.

NOTE: If you are planning on using a 5.5 mm diameter, use the medium dilator first and repeat the dilator steps with the wide dilator, following the medium dilator.

5- Placement of the implant:

While placing the implant, use a motor driven handpiece to control the direction of insertion.

Remember, because your osteotomy is as short as 2 mm and the self-grafting implant is going to determine its own final position according to angle of insertion. , you must take care to hold the implant firmly, in the proper direction, mesio-distally and bucco-lingually, in order to have the desirable angle and position of the implant.