Redo M

Five months post implant removal and bone graft, incision is made at #12.  Osteotomy is being done with guide until 3.0x7.3 mm drill with 1 O-ring (palatal wall being thin), followed by 3.2x17-19 mm sinus round drills and 2.2x11.5 mm drill.  After placement of 2 small loads of bone graft, a 4x9 mm dummy implant is inserted for sinus lift (Fig.1,2 *).  By this time, the buccal plate is gone, while there is apparently the palatal periosteum.  With more bone graft for sinus lift, a 4x9 mm final implant is placed with 30 Ncm (machine) and 4 mm subgingival (Fig.3,4 double arrows).  Sticky bone (Fig.5,6 *) is applied around the coronal end of the implant and cover screw (S), followed by 2 pieces of PRF and 4-0 PGA suture.  The sutures appear to have been dissolved and PRF membrane exposed 7 days postop (Fig.7,8 (smoker)).  The sinus lift remains (Fig.10 <), while bone loss appears to be present around the implant (Fig10,11 *).  After placement of 5.5x4 mm healing abutment and before suturing, allograft is pushed into periimplant space (Fig.12, 13 *). 

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Xin Wei, DDS, PhD, MS 1st edition 02/13/2020, last revision 06/24/2020