Introduction: Hydraulic procedures are reported to avoid any tearing forces on the sinus membrane. Hydrodynamic ultrasonic cavitational sinus lift (HUCSL) uses an ultrasonic oscillating water column to lift up the sinus membrane from the bone.

190 half fresh sheep heads were used for the investigation.

Design: An ultrasonic surgical machine (Piezotome ^® ) was tested to evaluate the pressure increase at different flow rates. The elevation-volume at different flow-rates and activation-times of the ultrasonic hand piece were measured. After establishing the technique 132 patients were evaluated clinically.

Animal study results: Comparing the different flow-rates, the elevated volume increased to 0.52 ml when a flow of 60 ml/min was used. Using an activation time of 20 s, a lifted volume of 3.92 ml could be measured in average. If the flow was set to a maximum of 60 ml/min, the created volume increased to 5.58 ml. A comparison by the chi-square test showed a significant correlation ( p = 0.03) between the application time and the created sinus-lift volume. Even at high flow rates of 60 ml/min of the activated Piezotome over a period of 20 s, no rupture of the sinus-membrane of the sheep heads occurred in 190 experiments.

Clinical results: The achieved augmentation volume varied from 1 to 5 ml dependant on the patients bone loss. No rupture of the sinus membrane was determined. The only documented complication was an instrument fracture of a diamond coated prototype.

Conclusion: Regarding these results, we conclude that hydrodynamic ultrasound could be used as an alternative method for sinus-floor elevations.

Conflict of interest: None declared.