May I use socket sinus lift (osteotome technique) in this case?

Hi dear dr.in my idea if you go for stage procedure prognosis is better. sinus augmentation with some vertical reconstruction on buccal and palatal wall. you dont worry about palatal flap this , you can do coronally advanced palatal flap with some releasing partial incision on flap base that i saw this technique first time in dr tatum cases. in other hand if you have adequate kt gingiva on buccal,help you to get primary tension free flap clousure.
good luck. Ali

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What is the width?

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This seems like a good case for internal lift approach. I prefer the Neobiotech SCA Crestal Kit with neurosurgical drills to access schniderian membrane and then the MIAMBE Balloon to lift the membrane without tearing.
All these techniques and products are featured on DentalXP and in the Product page section.
good luck
Dr. Salama

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why use a B size implant? With the Ankylos system(i prefer this as well) there is no mechanical or biologic benefit of using a 4.5diameter versus 3.5diameter. Based on your CT scan u can place the A size implant without needing GBR, and do osteotome sinus elevation.It also would align you implant placement with the buccal cusp of the lower molar..which is a better alignment for force distribution as well as esthetics. ... Seems a no brainer to me!

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I agree with Dr. Brad about size of implant and direction of force but how well does a 3.5mm diameter implant support molar forces LONG TERM?? Do we know enough? Possible implant or screw fractures?
Thanks Band

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Dear all colleagues.
Thank you very much for your prompt reply.
The width of the alveolar bone is only about 4mm.
I don't think a 3.5mm Ankylos implant (A size) is safe for upper molar even though many studies from Frankfurt University shows that it's safe to use A size implant in upper molar area.
Should I try A size implant in this case?
In case that the sinus membrane is broken because of the osteotome sinus lift, should I stop the procedure, close the flap and wait 02 months then try this technique again? Is it easier in the second time? Or should I do lateral sinus lift next time? I had about 5 cases with osteotome technique before and all were successful. So with me, I love this technique. I haven't tried the lateral sinus lift yet. I have SLA kit for safe lateral sinus lift from Neobitech. Is this case a ideal case to try this kit? Some of my friend say SLA kit is safe and effective. How do you think?
Thank you very much and looking forward to hearing from you soon.

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i have been using the Ankylos system for probably 8 years now. I have countless A size fixtures in molar sites with no problems.. I would not think twice about putting a full size molar on an A9.5 fixture.... probably the only system i would do this with... As far as the sinus lift questions... these are all the issues we deal with when doing these procedures.. yu could do a lateral window and place fixture at same time or do the the osteotome technque... if you perforate then you may need to extend to a lateral window to repair... this ispart of the surgical risks. you need to feel comfortable with both techniques if you are going to be lifting sinuses. And be able to repair or manage the potential complications.
good luck!

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Thank you very much for your advice, Dr. Bradford Klassman. I have more confidence to use A size Ankylos system.

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