Correction of Posterior Cross Bite with Bone Expansion M

A 56-year-old man (WG) had a stent placed in one of his coronary arteries approximately 1 year ago.  He has been taking Plavix (blood thinner).  The medicine should be stopped for a few days prior to surgery.  His dentition is poor (Fig.1).  Restoration of the upper right sextant is the 1st project (#2-4).  Not only does the bone height need to be addressed (Sinus Master Kit), but also the ridge is narrow.  It appears that the buccal plate is atrophic (Fig.2 arrowheads).  Because of the atrophic ridge and the wide lower arch (Fig.3), wax up teeth (Fig.4) have to be set up in cross bite (Fig.5).

To correct or alleviate the posterior cross bite, ridge split is initiated with wheel saws (Fig.6 black line) if CBCT confirms low bone density.  Bone expanders will be used to push the buccal plate buccally (Fig.7,8 arrow).

Internal sinus lift is chosen, because it is less invasive than lateral approach considering hemostasis.

Return to Upper Arch Implant Reconstruction, Systemic Diseases, 14,15, 18,19

Xin Wei, DDS, PhD, MS 1st edition 01/10/2016, last revision 01/14/2020