BMP ???

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Posted on By R. Terry Councill In Bio-modifiers: BMP-2 / PRGF

66 year old healthy male wishes to commence tx on the UL quadrant. Large sinus with horizontal bone loss. Considered sinus lift alone however this will lead to long lever arms and high torque on the implants. Would like to augment bone vertically. I am considering use of BMP. Would you do the same? If so How much? Would you also graft the sinus and if so Conventionally or with BMP? I have recommended the removal of implant #15(no bone not mine). Tooth #12 is fractured will be removed. Implants placed eventually in #12 and #14 positions to provide abutments for a 3 unit fixed partial denture. The goal is to provide first molar occlusion as #18 will be removed due to 9mm pockets. If BMP is used would you also use ti-Mesh or tent screws? Thanks for the help!!!!

Panoramic
implant 12

implant 15
implant 14 relative to 15


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4 Comments

Hi Terry would be great to view intra oral photos but initially would suggest sinus graft as this is far more predictable then onlay grafting,you will only achieve up to 5mm with one onlay graft. Not sure what you mean about long lever arms and high torque but if your meaning high crown to root ratio this only applies to teeth not implants.One would be more concerned about the bone density and bone implant contact ratio, you could also consider extra small implants .I would undoubtedly use prgf as bmp-2 is extremely expensive and will not improve the result of a sinus graft.


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Hi Terry

I agree, a traditional sinus lift first.. I utilize PRF and Mineross. I dont use BMP-2 in lifts, mainly on onlay grafts for ridge width.. Hope that helps. Jimmy


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Thank you guys so much. I will proceed with the plan as you have suggested.


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Agreed, I do not think that you would have any gained advantage to use of BMP here. Sinus lift and come back to place implants. If you could get three implants in Vs. a three unit bridge I'm sure the Pt would appreciate it.

jonathan


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Omnia
KLS Martin