- the patient had 5 implants placed 10 years ago by someone else
- implant bridge was loose, which i removed last year - 3 of the implants came out inside the bridge
- left the 2 firm implants in and did an overdenture on locators
- i augmented both sinuses - in feb 2017 (i struggled with the sinus grafts as well as my surgical area was just below the infraorbital nerve. just about managed to gain 1cm of bone in the molar areas.)
- don't know where to go from here - i could squeeze in 2 implants in the augmented sinuses with guided surgery
- i can't do any block graft for full maxillary reconstruction, or can I?
---- if i remove the remaining firm implants before blocks i would risk of breaking the nasal floor.
---- the bone is so paper-thin i wouldn't be able to screw fixate the blocks (during sinus window preparation the sinus membrane was already uncovered in some areas)
---- i would need at least 1cm of vertical augmentation!
any advice welcome.