Thank you very important question.
I'll tell you the question number.
(1) It is the moment when HATCH opens and CLE (Cutting Lifting Elevation).
Although accurate distance measurement is possible on CT, it is slightly different in pano (X-ray).
The hatch reamer is located on the side of the hatch rather than in the center, so when the hatch starts to open, one side of the maxillary sinus is deleted and the resistance is lost, while the other side is left with a bone that gives a sense of tilting resistance. Will be.
After deleting the other side where the bone remains, the hatch reamer's cutting head reaming head does not delete and feels as if it doesn't have any resistance.
If you're on a flat surface, you'll have a very short gap and the slope will be longer.
If the speed is a little faster, the time feels shorter.
Sometimes the maxillary sinus is very thin or weak.
If you feel your hand as the experience repeats, you will be sure to know the moment of the moment of opening.
Stop at this stage or go a bit more slowly 1mm.
If you promote it with a gauge, you can feel the elasticity of the maxillary sinus membrane.
If you add bone chip at this stage and advance about 2mm, the bone chip will move to open gap while hatch is fully opened and the maxillary sinus will be lifted.
If you promote it with a gauge, you can feel the elasticity of the membrane.
If you feel more advanced at the measured length but still do not feel the hatch open, check with the gauge.
1) hard bone – more advanced
2) Check some elasticity – CLE by moving forward after bone graft
3) Elasticity not stiffness – Confirmation of elasticity by condensing after bone graft (loss of elasticity during membrane perforation)
4) Feel the airlessness without elasticity – stop and suture when checking the puncture by blocking and testing the nose
Another important tip!
Is the hatch open? Didn't it open? When in doubt
– If you fill the bone chip and move forward, membrane perforation will never occur.
(2) He gave me an accurate representation of how to use it.
The moment the hatch is opened (the hatch reamer feels tilted) stops rotating and fills the bone chip with the formed hole.
Afterwards, if you move forward comfortably about 2mm, the hatch will be opened while the resistance is gone while the resistance is lost.
If you are anxious in the middle, please add bone chip and move forward.
(3) On the inclined side, the hatch feels long after being opened.
In this case, the inclined maxillary sinus is removed and pushed in to push the maxillary sinus membrane.
Rather, safe sinus lift and bone graft are possible without additional bone grafts.
If you are anxious, go forward 2mm, then bone graft and repeat the advancement to the desired length.
Contrary to usual thoughts, it is safe and easy without the need for additional bone grafts on the slope or septum.
Implant surgery is possible.
If in doubt or anxiety move forward after additional bone graft.
(4) The diameter of the hatch reamer to be used depends on the diameter of the implant to be placed and the bone quality.
While a 3.5mm hatch reamer may be useful for placing a 4.1mm ITI type implant, there may be cases where you need a 2.5mm hatch reamer if you have poor bone quality or few bones.
Sometimes the remaining bone is very weak and about 1-2mm in case of only the primary bone graft and sinus lift
Please note that you may need a hatch reamer larger than 3.0.
Thank you so much for the good question.
