The use of hydraulic force to condense bone particulate into the maxillary sinus is a predictable and less invasive method of site preparation for many, but not all, dental implant candidates. It is our approach in the primary indication for HSC--patients with advanced periodontitis in whom insufficient cortical bone at the alveolar ridge of the posterior maxilla stands as a detriment to effective implantation. A second indication for HSC accounts for those patients who suffer blood disorders or have sensitivities to certain medications, such as vasoconstrictors, and in whom it is crucial to manage bleeding during surgery. In these cases, changes in the armamentarium used for the procedure can effectively accommodate special needs. These clinical cases were followed for 10 years to show the continued success of the HSC technique.
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