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Considering severe bone loss and bone height (sinus floor: red dashed line in Fig.3), a long (18 mm) narrow UF implant will be placed away from the lesion (most likely palatal if the buccal plate is lost) and deep with possible using 5-mm cuff abutment. To further prevent periimplantitis, smoke reduction is to be enforced preop (ask the patient about the cessation with care immediately prior to surgery) and PRF membranes (2-3) will be placed over the defective plate and into the sinus if needed.
Xin Wei, DDS, PhD, MS 1st edition 01/21/2017, last revision 01/19/2018