When Bone Height is Sufficient

Implant placement at #31 reveals that bone width (bucco-lingual) is not a problem for a 64-year-old man.  He requests implant placement at #7 and 14 (Fig.1,3), because the upper flipper has been lost.  He wants to make sure that the implant at #7 does not cause the pain at #6.  In fact the flipper appears to have lead to caries (Fig.2 *) and periapical radiolucency (<) at #6.  RCT is rendered at #6 prior to a 1-piece implant at #7 (Fig.1).  Since bone height is sufficient, the implants do not have to penetrate the nasal floor (Fig.1 v) or the sinus floor (Fig.3 <) unless the bone density is low.  Prepare implant positioner of 4 mm to determine whether the ridge is wide to hold a 3.8 or 4 mm implant.  Take preop photos to show the ridge width.

Re-analysis of #14 edentulous area reveals slightly unfavorable crown/implant ratio if the implant reaches the 1st line of the sinus floor (Fig.4).  A 5x13 mm implant may invade the 1st line (Fig.5).  Therefore the depth of osteotomy using 4.8 mm Magic Drill is 9-10 mm (Fig.6 green), followed by Magic Sinus Lifter, unless the bone density is high.

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Xin Wei, DDS, PhD, MS 1st edition 08/28/2016, last revision 11/13/2016