Crestal sinus elevation/ immediate placement with NO GRAFT

137 Rating(s).

Posted on By Charles Schwimer In Sinus Augmentation

Case was treated 14 years ago. Crestal Osteotome performed with IMZ internal irrigated spade drills and Zimmer Advent implants. NO GRAFT. Most recent CBCT is 24 years PO. Just a reminder of how the sinus potential for healing.

Pre tx 2004
Implants placed 2004

IMZ instrumentation
PA 2018

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Hi Chuck! It was a pleasure to meet you in person finally. I love your cases especially this one where premolar has huge infection. I think your patient needs a full rehab!)))) Best Regards, Gregory


Hi Gregory. It was a pleasure to meet you also. You are absolutely right!!I have been working on that almost 15 years now.This patient has been procrastinating for over 10 years. I finally got her to agree the extract and implants the #12 region.then to naive down to address her Mandibular anterior region. Be well my friend


Remarkable. Can you provide is with your narrative and biological aspects of what happened here? Thanks for sharing. Mo


Hi Mo. It was done a long time ago but I will do my best to explain. I placed a dimple in the ridge for each implant site with a round bur. Then carefully and incrementally drilled to
the sinus floor with internally irregated spade drills. I was able to release the sinus membrane with the hydraulic pressure. This was purely coincidental because back then I had no idea about HPISE. I then used the implant as a rotary Osteotome by placing it into an undersized Osteotomy and tenting the sinus membrane. The space filled with whole blood and I presume the whole blood clot was replaced by bone growth from the lateral walls cans sinus floor.


Great, Chuck.
I remember a lecture at AAP ages ago...speaker has shown numerous cases and videos of crestal elevation utilizing high speed and diamond burs, actually hydraulic pressure.
Great minds think the same :)
Thank you for sharing, always inspiring


One of my Russian dentist friend showed the case similar to yours where he was trying to raise sinus membrane and it shattered. He tack membrane to the ridge and since implant was floated he attached it with titanium mesh also to the ridge. It was thinking out of the box!)))


Chuck, when things go straghit we have to!
You did perfectly here and nature did the rest.


Henry Schein