The piezoelectric bony window osteotomy and sinus membrane elevation: introduction of a new technique for simplification of the sinus augmentation procedure.
All of the surgical techniques to elevate the maxillary sinus present the possibility of perforating the schneiderian membrane. This complication can occur during the osteotomy, which is performed with burs, or during the elevation of the membrane using manual elevators. The purpose of this article is to present a new surgical technique that radically simplifies maxillary sinus surgery, thus avoiding perforating the membrane. The piezoelectric bony window osteotomy easily cuts mineralized tissue without damaging the soft tissue, and the piezoelectric sinus membrane elevation separates the schneiderian membrane without causing perforations. The elevation of the membrane from the sinus floor is performed using both piezoelectric elevators and the force of a physiologic solution subjected to piezoelectric cavitation. Twenty-one piezoelectric bony window osteotomy and piezoelectric sinus membrane elevations were performed on 15 patients using the appropriate surgical device (Mectron Piezosurgery System). Only one perforation occurred during the osteotomy at the site of an underwood septa, resulting in a 95% success rate. The average length of the window was 14 mm; its height was 6 mm, and its thickness was 1.4 mm. The average time necessary for the piezoelectric bony window osteotomy was approximately 3 minutes, while the piezoelectric sinus membrane elevation required approximately 5 minutes.