4 internal Sinus lift+ 2 bone enhancement with Densah

216 Rating(s).


Posted on By Jorge Campos In Sinus Augmentation

A woman on the 60 needed posterior teeth. Implant had bone limitations on the width on some areas of bicuspids and height limitations on molar sites on both sides. The use of Densah burs made the task easy.
On the bicuspid area I began with a cortical split with a diamond disk before the use of the pilot drills.
After mesuring two 3.5 implants were inserted with no external exposure.
On Molar sites sinus lift with Densah burs were done with no graft inserted. Just autograft.
CBCT images and messures were similar to caliper mesurments.
Because I could avoid window lift I had time to improve cuspid tissue level with a tuberosal graft.
All implants were above 40 nw.
Regards
Jorge




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26 Comments

Sinus lift


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Final case. See bicuspid sites improvement


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See buccal bone and CTG


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Distribution was carefully mesured with Plantilla Clinicae


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CBCT shows sinus lift bilateral.


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Jorge, this is a marvelous work. Beautifully managed. And a superb balance between surgical skills and mininvasive procedure! The x-ray control proves the quality of rehabilitation and the bone saving promoted by the use of densah drill. I see you performed some longitudinal cut to enhance bone expansion: what were you doing before the densah drill to solve this case, and how long would have taken? Best regards, my friend. Armando


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Hi Armando, in cases like this I would do a corticotomy and then use screwed expansors just to separate the two tables. Or a GBR or Block graft....Techniques that would take much more time and efforts.
Regards my friend
Jorge


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Jorge. FABULOUS CASE for 2016! Soon to be a ROUTINE STANDARD OF CARE. You have put it together well my friend! See you soon:-). Chuck


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Chuck I do agree with you, this tech is minymally invasive and is not related with Dr. skill. Low curve learning and everybody can do easily. As you said, may be the Standard of Care some day.
See you soon! Jorge


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Jorge, my compliments and admiration!
I bet you enjoyed this surgery. It gives such a good feeling - performing minimal invasive surgery knowing that this is the best treatment approach nowadays.
After initial cutting the ridge with (unprotected!Jorge action hero) a saw, did you open a space with chisels?
Best regards
Snjezana


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HI Snjezana, thanks very much for your compliments!
Yes I really enjoyed the surgery and added a CTG...:-)
The mini disc, unprotected, was used for initial 4 mm depth groove. NO chisels, just Densah burs.
Thanks for commenting.
Regards
Jorge


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Great Case! It was a pleasure to meet you personally and shake your hands! Gregory


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For me too Gregory! Hope to see you soon again!
I´ll be at Orlando WOS, january...perhaps...
Jorge


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Jorge; Great case management ALL the WAY thru....as you say each and every detail considered and clinically mastered. Well done. Mo


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Thanks for your kind words Mo! Really apreciated for me.
As you know complex cases must be resolved with a hollistic view. Here we have to do many things at the same time, and with this tool, the Densah, I work faster... and more predictable.
Regards
Jorge


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Jorge,

Very nice! Densah world! How much coverage would you anticipate gaining from tuberosity graft ? Prosthetically what do think do ? Pink - multiple bridges?

Cheers,

Richard


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Hi Richard. I´ll improve cuspid neck biotype. May be a gain of 1mm. Final prosthesis will be 6 zirconia crowns and screwed bridges. Perhaps with a new CTG at uncovery to avoid pink ceramics. I think it is possible.
You have keen eye! It is a nice observation.
Regards
Jorge


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Jorge,

Bravo! Goldeneye

Cheers,

Richard


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Congratulacions!
Beautiful case!
Do you think you could have enhanced the same kind of expansion in a hard bone like the mandible? Would you use chisels in the mandible?


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Would you add vertical cuts as well in very dense bone situations? regards Mo


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For sure Mo.
If needed the vertical cuts are helpfull.
Regards
Jorge


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If vertical cuts are necessary perhaps you are going beyond the elasticity of the bone and not satisfying the criteria for effective OD?


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Hi Margarita.
With hard thin bone the cuts are neccessary.
I prefer to use CCWDensah to separate the cortical plates.
Regards
Jorge


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Jorge, great technique can you tell me what company makes that mini disk. Thank you


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Henry Shein , Omar.
Jorge


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this is the great idea.


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