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The longest (12 mm) bone trimmer seems not to work over the guide at #15. When osteotomy finishes, the guide is removed. The sinus floor happens to have been removed, whereas the sinus membrane remains intact. After partial insertion of a piece of PRF membrane (due to hemorrhage) and Vanilla graft for sinus lift, a 5x10 mm implant is placed with 15 Ncm. The implant appears to be short and placed deep (Fig.1,2). When an implant is not too large, it can be placed ~ 1 mm subcrestal (vs. 2-3 mm for this case) in spite of the palatal wall defect. A cover screw is used, followed by allograft (Fig.1 *). The latter is covered with another piece of PRF membrane, collagen membrane and periodontal dressing.
Xin Wei, DDS, PhD, MS 1st edition 09/29/2018, last revision 12/21/2018