Sinus lift with Osteotomes without Bone Graft

A 61-year-old man has generalized moderate localized severe periodontitis (Panoramic X-ray).  An immediate implant has been placed at the lower right 1st molar. 

A 6x11 mm tissue-level implant will be placed at the upper right 1st molar site (Fig.1).  Bone expansion starts with #11 blade, followed by blade and round tapered osteotomes and 4.5x11 mm tap drill (Fig.2: T).  It appears that the sinus floor has been lifted (Fig.2 *).  After use of 5x11 and 6x11 mm taps, a 6x11 mm implant is placed with insertion torque > 60 Ncm (Fig.3: I) with sinus lift without additional bone graft (*).  The implant is surrounded by the gingiva and bone (Fig.4 arrowheads).  No suture is required.  There is no bone loss 10 months postop (Fig.5).  The implant has been in function for 3 years and 9 months.  The gingiva is healthy.

Upper Molar Immediate Implant, Sinus Lift, 10, 14/15, 18

Xin Wei, DDS, PhD, MS 1st edition 06/23/2013, last revision 02/16/2018