Part 1. 2-Visit replacement Protocol. First molar + sinus lift.100% CAD-CAM

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Posted on By Anton Andrews In Sinus Augmentation

2-visit tooth replacement protocol was developed by Dr. Anton Andrews at DENTOLOGY. This time it is utilized to replace a hopeless upper left first molar. Proximity of the maxillary sinus required a sinus elevation which was performed during the same surgery.
Utilization of Partial Extraction Technique - PET, allowed the creation of the Socket Shield which will prevent bone resorption on the buccal (cheek) side. 3D intraoral digital scanning was also done with TRIOS scanner to register the position of the implant, making it possible to deliver the final implant crown at the next visit.
BETTER QUALITY VIDEO IS AVAILABLE HERE
https://youtu.be/rqk0v3c_J2o
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9 Comments

Very nice....when are you going to show the final restoration insertion? Thanks Dr. Salama


Reply

Thanks Maurice, the final will be in about 5 months.


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Anton. Beautifully conceived and executed protocol. Have you tried the Densah burs yet. You could obtain a similar outcome only more simplified. In addition, you probably could have used a smaller diameter implant if desired. I realize you prefer the widest implant possible for these sites, but you will not always have room for a 7mm fixture and PET.Great case and video! Thank you for sharing.Best regards. Chuck


Reply

Thx Charles, I started the osteotomy with 4 mm outer trephine from Dr. Lee kit, final 1 mm did with piezo. I have tried Densah and liked them a lot. For this case it would be hard or impossible to use since the osteotomy went through 1/3 of the circumference of the palatal root socket. A trephine had worked betted for me. A Smaller diameter implant would had not been stable enough , 7 mm was great. Sometimes I use 5.8 diameter laser look plus from biohorizon - on lower molars with less wide alveolar bone.
I'll post a couple nice cases for all on6 done with Densah burs.


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Nice vertical sinus lift, on the post-op CBCT it appears that you left the two buccal roots complete and did not reduce the buccopalatal width. Can you comment on why you used this approach and not the standard PET protocol?


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Hi Jerome,
I trimmed the buccal roots all the way to their apices leaving only the buccal 1/2
look at 1:31 min in video. you'll see it


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Anton,

Nice case- I thank you for contribution to the site and are masterful in digital -I have a few questions- Why both PRP& PRF- have we not seen just PRF used in this case in other posts- why PET in such a cutting edge case? do you think you will have that much buccal resorption? isn't one of the reasons you use a 7mm implant is to support the plate- What was your seating torque what is the restorative platform? what is the vertical position of the implant and if you scanned at time of surgery can you show us the proposed restoration?

Cheers,

Richard


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Thank you Richard,
Why both PRP& PRF- have we not seen just PRF used in this case in other posts-
I like to use PRP enriched BG, it comes in one piece, which is easy to handle and sticky bone integrates faster due to growth factors

why PET in such a cutting edge case?
Just because I could do it to prevent buccal bone collapse

do you think you will have that much buccal resorption? isn't one of the reasons you use a 7mm implant is to support the plate-
7 mm implant will not support the plate, but on contrary it might affect blood flow in the area so PET is beneficial

What was your seating torque
45 NCm for this case
what is the restorative platform?
5.7 zimmer
what is the vertical position of the implant?
the healing abutment is 6mm tall, so please do the math

and if you scanned at time of surgery can you show us the proposed restoration? I will in 5 months, I do not design until 3 weeks before the final appt.


Reply

Anton,

Thanks for detailed response- doesn't the design studio do the math? Heck,its digital technology.

Cheers,

Richard


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