Maurice Salama - (2/20/2011 11:33 AM)

Mark;
If you can idnetify the bleeder you can use a cautery like a radiosurgical instrument or if not I have successfully utilized Hemcom from Zimmer for 5-10 minutes then remove prior to grafting.
Dr. S

Mark Neale - (2/20/2011 8:21 AM)

I am interested in other techniques to control bleeding with LW sinus osseous augmentation. Presently I use a sterile gauze soaked in 1:50,000 epi. simple placed internally prior to grafting. On some occasions where I have nicked a vessel I find this marginal effective. I am interested in what others do.

Mark Neale - (2/20/2011 8:21 AM)

I am interested in other techniques to control bleeding with LW sinus osseous augmentation. Presently I use a sterile gauze soaked in 1:50,000 epi. simple placed internally prior to grafting. On some occasions where I have nicked a vessel I find this marginal effective. I am interested in what others do.

Maurice Salama - (1/1/2011 2:29 AM)

As it is does not offer growth factor release and resorbs quickly, I prefer PRGF.

Dr.Valentin Petrov - (12/31/2010 3:22 PM)

Hello, Dr.Salama .I woner if using Calcium sulphate as an overlayer with no PRGF , would it be a good alternative to membrane in such lateral sinus cases .
Thanks for the video.

Ziv Mazor - (1/24/2010 11:56 AM)

Hi Milind,
As Dr Salama stated with minor perfs sealing with either collagen membranes or even PRF should do.Sometimes after elevation of the membrane it folds on itself sealing the perforation.With larger perforations I would use either a collagen pouch-Loma Linda pouch or a large collagen membrane.
As for the sinuses grafted with PRF only-most of my cases I still mix my graft with PRF .I think we have to wait for long term results before heading to no grafting.

Maurice Salama - (1/24/2010 6:02 AM)

Milind; With minor perforations you can use a collagen membrane to "seal" these perforations prior to packing your graft material. This has been shown nicely by Dr. Pikos. As for the article regarding lifting the sinus and placing implants without Bone Grafting that was recently published in the Journal of Perio by one of the Xperts, Dr. Ziv Mazor who only utilized Choukroun's PRF to gain bone volume and the apical portions of the implants acted as support pins to maintain the regenerative space below the sinus membrane.
I think this works but I still prefer to add bone graft material with PRGF and fibrin into the sinus for my lifts.
I will be taking Dr. Mazor's 2 Day Sinus Lift Hands-on course here in Atlanta April 16-17th. This should be a dynamic course by one of the very best in our field.
Dr. Salama

milind saudagar - (1/23/2010 10:24 PM)

dr.salama, excellent surgery. what happens if there are minor perforations?. i read an article somewhere that you just lift yhe sinus membrane, do osteotomy 7 put an implant. ther is no need to add bone material.studies showed that bone formed around implants. i was not convinced. what do you say?

milind saudagar - (1/23/2010 10:24 PM)

dr.salama, excellent surgery. what happens if there are minor perforations?. i read an article somewhere that you just lift yhe sinus membrane, do osteotomy 7 put an implant. ther is no need to add bone material.studies showed that bone formed around implants. i was not convinced. what do you say?