Prior to placement of 5.5x9 mm IBS implant (~ 35 Ncm, Fig.5), a piece of Osteogen plug is inserted into the osteotomy for repair of the perforation.  The final implant is also shy of the sinus floor (^).  The Osteogen plug is apparently placed underneath the sinus floor so that it should be able to repair hard and soft tissue defects.  The remaining sockets are mainly filled with Osteogen plug, while the implant plateau is covered by autogenous bone and Osteogen.  A 6.5x4(3) mm abutment is placed for an immediate provisional.

The patient returns with chief complaint of crown is loose with pain 2 months postop (Fig.7).  Under local anesthesia, the provisional is removed.  The gingiva is erythematous.  The implant has mobility.  A healing abutment is placed (6x2 mm).  Probably a large implant should have been placed.

The implant appears to be osteointegrating 3.5 months postop (Fig.11).

Repair Sinus Membrane Perforation

Xin Wei, DDS, PhD, MS 1st edition 12/29/2016, last revision 01/19/2018