After using 5x11 mm tap, sinus lift is accomplished with allograft.  A 5.5x10 mm UF implant is placed with a latch driver with insertion torque > 65 Ncm.  Wrench does not seat the implant as deep as expected.  It appears that the implant does not go through the sinus floor.  The implant is removed, followed by tapping RT 2-4 deeper.  When 4.5x11 mm tap is being reused, the sinus membrane is perforated.  Osteogen plug is inserted, followed by the implant, which is placed deeper than expected with low stability (Fig.2). 

Perforation Last Next

Xin Wei, DDS, PhD, MS 1st edition 06/21/2016, last revision 05/24/2019