Sinus Lift with Guide
Designed osteotomy depth is 7.3 mm IS drill with 4 rings at #15. In fact osteotomy is created using 2.2 mm drill with 2 rings (sinus membrane barely visible from the osteotomy) and 3-4 mm ones with 3 rings. With an amalgam carrier of bone graft, sinus lift is initiated with 4x9 mm dummy implant (Fig.1). After loaded with totally 5 amalgam carriers of bone graft repeatedly with the 4x9 mm dummy implant, a 5x9 mm implant is placed with ~ 25 Ncm. After insertion of a 6x4(2) mm abutment, sticky bone cut into pieces (Fig.2) is inserted to peri implant space (Fig.3 *), followed by PRF and an immediate provisional. The latter dislodges 7 days postop; the socket starts to heal (Fig.4); the bone graft seems to be fixed in place. The provisional is reseated (no cement, Fig.5) without fear of its dislodgement again. The patient returns for cleaning 1 year 7 months postop (Fig.6,7). The socket heals, while the abutment is incompletely seated (Fig.7 <). Percussion at #18 disappears post RCT, whereas periapical radiolucency appears post RCT (compare Fig.8,9). When the 6x4(2) mm incompletely seated abutment is removed, the implant well is dirty. The smaller abutment with longer cuff is seated fully (Fig.10).
Return to Upper Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table) Trajectory II 开场白 Xin Wei, DDS, PhD, MS 1st edition 11/06/2019, last revision 07/20/2021