PRF with Sinus Lift and Implantation
While the base of the ridge at #14 is wide, the top is moderate. IBS Magic Split is applied to gain access and test bone density (flapless). In fact the bone is hard. A 1.6 mm pilot drill is used for 9 mm (gingival level), followed by insertion of a parallel pin (Fig.1). Following Magic Expander 3.0 mm and Magic Drill 3.8 mm for ~ 11 mm (with empty feeling without air leak), a 4x11 mm dummy implant is placed with 25 Ncm (Fig.2). After insertion of a 4.5x11 mm dummy implant at 9 mm (35 Ncm; for further bone expansion), one piece of PRF plug and 1 piece of PRF membrane are pushed into the osteotomy, followed by allograft mixed with autogenous bone for sinus lift and placement of a 5x9 mm implant (Fig.3,4 with insertion torque >50 Ncm). A 6x4(2) mm abutment is placed for fabrication of an immediate provisional (Fig.5 P). There is no nasal hemorrhage postop. PRF membrane and plug are used to prevent and repair sinus membrane perforation and facilitate wound healing. There is mild bone resorption at the crest 11 months postop (Fig.6,7). The bone resorption seems to be worse 8 months post cementation (Fig.8,9); in fact the abutment screw is loose.
Return to Upper Molar Immediate Implant Xin Wei, DDS, PhD, MS 1st edition 04/28/2017, last revision 05/05/2019