Narrow Ridge

Preop exam shows the narrow ridge at #14.  Magic split is used for access and initiation of osteotomy and bone expansion, followed by 3 mm Magic Expander for 11 mm (ME, Fig.1 (yellow line: sinus floor)).  In fact the bone is soft.  After use of 3.8 mm ME and Lindamann bur (to move the osteotomy distobuccally), a 4x11 mm dummy implant is placed with 20 Ncm (Fig.2).  Following use of Lindamann bur for the same purpose as mentioned above, a 4.5x9 mm IBS implant is placed 3 mm subgingival with <30 Ncm (Fig.3,4).  Bone graft is placed for sinus lift prior to implantation.  A 5x3 mm healing abutment is placed.  Bone loss is minimal 3.5 months postop (Fig.5) and striking 8 months postop (after crown cementation, Fig.6-8).  The bone loss persists in spite of crown and abutment removal (Fig.9,10).  Bone graft or implant redo is planned.

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Xin Wei, DDS, PhD, MS 1st edition 07/27/2017, last revision 07/18/2018