extraction sinus lift and immediate implant placement

3 Rating(s).


Posted on By THEO ODYSSEOS In Implants

pt presented with a periodontal compromised tooth( #16).tooth was one of the 2 abutments supporting a FPD.tooth (bridge)was sectioned and carefully extracted leaving an intact socket.an osteotomy was performed for placing an immediate implant through the trifurcation and at the same time the sinus membrane was elevated in order to place a longer implant.intitial bone heigh was 4-5 mm.the socket was grafted with xenograft and left for 5 months for osseointegration.a CAD/CAM Zirconium crown was fabricated to replace the missing tooth.


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4 Comments

Hi Theo, great job!
How did you do the sinus lift?
Wouldn´t be possible to insert another implant for the 2nd bicuspid?
Thanks for posting
Jorge


Reply

hi Jorge , happy new year and thanks for your commend.the height of the bone was 4-5 mm and i used a straight hand piece and a diamond coated round bur (3. 00 mm) removing the bone till the scheiderean membrane, then proceeded like a regular sinus lift using small diameter elevator plus placing the bone graft.
yes i could have placed another implant ,the reason for not placing is $$$$$.occlusion was adjusted for very light occlusal and no lateral contact on site movement on the first bicuspid.
thanks again my friend.


Reply

Theo. Great execution of IMO an obsolete approach to this type of case. Clearly you do not use Densah burs. Given the morphology of the bone remaining after extraction, this case could have been managed solely with autogenous bone from within the socket. No need for Xenograft at all! BTW what purpose does the Xenograft serve in the Osseodensification process? BTW I love the prosthetics. Great case for discussion. Best regards. Chuck


Reply

thanks for the commend, i do not have the densah burs in my office, second i had only 4 mm in height i.e. not enough bone to elevate the membrane, third i did underdrilling for better primary stability fourth you can not leave the autogenous bone exposed after filling the socket(roots)

“Use of Xenografts for Sinus Augmentation” – The Sinus Bone Graft by Ole Jensen.

Stuart J. Froum, DDS
Stephen S. Wallace, DDS
Sang-Choon Cho, DDS, BDS, MS
Dennis P. Tarnow,
conclusion:
"Xenograft is the unheralded success story of sinus graft augmentation. When used by the prescribed methods elucidated were, xenograft is better than autograft or allograft at maintaining load-bearing bone volume, with a high percentage of vitality, safety, and lack of complication. Though xenograft is not the material of choice for bone graft reconstruction in general, for the sinus floor graft site and for the sole purpose of dental implant osseointegration, it may be the graft material of choice."
thanks Theo

day of surgery
post op 10 days


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