Magic Drill As Tissue Punch

The long 4.8 mm Magic Drill (MD) is used as a tissue punch at the site of #14.  After use of a curette to remove the tissue, the MD is used for osteotomy.  In fact the osteotomy is mesial with an increase in the osteotomy depth.  Magic Lifter, Magic Expander (3 mm) and Magic Drill (3.8 mm) are used to finish sinus lift.  Following placement of PRF and Vanilla Graft, a 4.5x11 mm dummy implant is placed (Fig.1,2).  The osteotomy seems to be mesial.  After use of Lindamann bur distally and 2nd round of PRF membrane and Graft, a 5x9 mm implant is placed > 50 Ncm (Fig.3,4).  The final implant appears to remain mesially radiographically.  Retrospectively, 1.6 mm pilot drill should have been used with insertion of guide pin after tissue punch.  Change in osteotomy position would have been much easier at the early stage.  The patient returns for impression 3 months postop; There appears to be space mesial to the implant (Fig.5).  The permanent crown will be cemented 2-3 months later.  No screw loosens probably related to mesial placement of the implant.

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Xin Wei, DDS, PhD, MS 1st edition 02/05/2018, last revision 08/18/2019