Ziv when is the next balloon course.?

What is you opinion on the osseous tech balloon that people are using for a later window in this thread?

I agree with Mouse.

I have used this balloon for lateral windows.

http://www.osseoustech.com/balloon.html

It definitely minimizes manipulation with instruments and ultimately sinus perfs.

John

Ziv your balloon looks exciting. Any other papers on the horizon?

Also for your hands on course in Europe, do you provide live patients for the course attendees to work on? Or is it over the shoulder?

Ted

Where can I learn more about this technique and where can you buy a balloon?

Can this technique be done with an lateral window?

Do you always place the implant at the time of the lift or do you do it in a two stage fashion?

Ziv in one of your posts below you said on 5/11/2010:

Perf rate with the balloon
In my experience it is about 8%. The more you are experienced the less perf you will get.

However in the two articles below (one being yours)not using a balloon only piezo there is a 7% and 3.6% perf respectfully.

Why use the balloon with a 8% perf rate as you say when I can just use the piezo and get less of a perf rate?

I am eager to hear your response.

Shaz

Here are the articles for your reference:

Schneiderian membrane perforation rate during sinus elevation using piezosurgery: clinical results of 100 consecutive cases.
Wallace SS, Mazor Z, Froum SJ, Cho SC, Tarnow DP.

New York University Department of Periodontics and Implant Dentistry, New York, New York, USA. sswdds.sinus@sbcglobal.net

Abstract
The lateral window sinus elevation procedure has become a routine and highly successful preprosthetic procedure that is used to increase bone volume in the posterior maxilla for the placement of dental implants. Many surgical techniques have been proposed that provide access to the maxillary sinus through the lateral wall to allow for elevation of the sinus membrane. Among these are the multiple variations of the hinge and complete osteotomy techniques, which make use of rotary cutting instruments for the antrostomy. The most common intraoperative complication with these surgical approaches is perforation of the schneiderian membrane, with perforation rates of 14% to 56% reported in the literature. In most instances, perforation occurs either while using rotary instruments to make the window or when using hand instruments to gain initial access to begin the elevation of the membrane from the sinus walls. This article presents an alternative approach that uses a piezoelectric instrument for the sinus elevation procedure. Although new to the United States, this approach has been used successfully in Europe for many years. The membrane perforation rate in this series of 100 consecutive cases using the piezoelectric technique has been reduced from the average reported rate of 30% with rotary instrumentation to 7%. Furthermore, all perforations with the piezoelectric technique occurred during the hand instrumentation phase and not with the piezoelectric inserts.

The effect of piezoelectric use on open sinus lift perforation: a retrospective evaluation of 56 consecutively treated cases from private practices.
Toscano NJ, Holtzclaw D, Rosen PS.

Private practice, Washington, DC, USA. navygumdoc@aol.com

Abstract
BACKGROUND: The lateral window approach to maxillary sinus augmentation is a well-accepted treatment option in implant dentistry. The most frequent complication reported with traditional techniques has been the perforation of the Schneiderian membrane, with perforation rates ranging from 11% to 56%. The purpose of this retrospective, consecutive case series from two private practices was to report on the rate of Schneiderian membrane perforations and arterial lacerations when a piezoelectric surgical unit was used in conjunction with hand instrumentation to perform lateral window sinus elevations. METHODS: Clinical data (Schneiderian membrane perforation, Underwood septa, and laceration of the lateral arterial blood supply to the maxillary sinus) were obtained retrospectively from two private practices and pooled for analysis. The information was collated after an exhaustive chart review. Fifty-six consecutively treated lateral window sinus lifts were performed on 50 partially or completely edentate patients. RESULTS: Zero perforations of the Schneiderian membrane occurred during the piezoelectric preparation of the lateral antrostomies, whereas two perforations were noted during subsequent membrane elevations using hand instrumentation. In both instances, membrane perforations were associated with sinus septa. The overall sinus perforation rate was 3.6%. Arterial branches of the posterior superior alveolar artery were encountered in 35 cases, and there were zero instances of arterial laceration. CONCLUSIONS: This retrospective case series from clinical private practices confirmed that a lateral window approach to sinus elevation incorporating piezoelectric technology in conjunction with hand instrumentation was an effective means to achieve sinus elevation while minimizing the potential for intraoperative complications. Further prospective and randomized controlled studies are warranted to qualify these observations.

I dont see what is so great about the balloon. Piezosurgery reduces the risks and complications of sinus perforations to 3-5%

What is the perf rate with the balloon???

I would be more excited if it didnt seem like there where more motivations to sell something then advance science.

Shaz

Dr. Salama thanks for sharing. The balloon looks like it can cause a paradigm shift in sinus grafting.

For those that are going to be in Boston can we meet for lunch to review the Balloon?

I saw the dental xp video and I dont see what the buzz is about. This to me is another passing fad. As an oral surgeon I been doing sinus lifts for years with minimal complications.I dont see how the balloon will change that. I have used the balloon by zimmer and dont see the benefit. I dont see how an gauge can make a difference. Seems to me people are just trying to sell something to the GP.

Dear Ziv,

Any new papers coming on the balloon?

Also any feedback from your students that have taken the course on how they like the balloon once they try it in practice?

I am looking to take you next course.

Brooke.

There is no doubt you are an accomplished surgeon and the balloon is exciting, but I believe you are simplfy the surgical procedure a little. Don't you think it it a little daring to have a GP take you day course and expect them to do a complicated procedure such as a sinus lift?

You been doing this for years, how can you expect them to learn this in a day?

Logan

I been doing implant surgery for about 2 year. I am a graduate of Misch.

I do lots of grafting including infuse grafts. I do open and closed sinus lifts and I have a 15% perf rate on open lifts and closed its hard to quantify as you will never no if you perf.

My questions are:

Does this eleminate the need to use an osteotome lift there by getting rid of the need to bang on a patients skull?

Does this reduce complications?

Will this be a good tool for a General Dentist to incorporate sinus lifts in ones practice?

I just started doing osteotome sinus lifts. Took Gargs implant training course and I am placing my own implants. I have done some closed sinus lifts but I am apprehensive. Will the balloon make it easier for me to do a sinus lift or should I refer?

What benefit are you seeing with the balloon lift and Dr. Lee's lift technique?

For any lift over 4mm, I prefer an open lift. To be quite honest, they can be performed rather quickly (60-90 min) and the patients rarely complain of any post-op pain. Plus, the results of the open lift simply cannot be beat.

I see the results of the balloon lift and Dr. Lee's lifts, and while they obviously seem to work, those techniques just don't look like they provide as nice of a result in terms of bone fill as the open lifts. I like to have at at least 2mm of bone apical to the apex of my implants. With many of those other techniques, it often appears that there is zero bone apical to the apex of the implant after healing.

Plus, if you have a perf, you may not even realize it. If you do see that you have a perf, with these techniques, you are working through such a small window that it would seem difficult to repair.

I'll admit that I have not tried the balloon technique or Dr. Lee's technique. The open lift just works so well for me that I have a hard time finding a reason to change.

Your input is appreciated. Thanks

I am curious on what the current reduction in perforation rate is using this balloon?

Ziv I understand that the pump controls the pressure in the balloon. But can you gleam any other info from the pump in terms of the actual lift?

After I saw this case I went out and bought the ballon by Zimmer and dont see what is special. I actually had problems controlling the lift and the balloon wanted to attach to the membrane. I dont see the value.

When is the next balloon course?