After placing PRF membrane and Vanilla graft for sinus lift (Fig.13 *), a 4.5x10 mm definitive implant is placed with loss of control in the trajectory (Fig.12,13).  * in Fig.12: bone graft around the implant.  Because of hemorrhage, deep position and block of the bone graft for sinus lift, it is difficult to control the entry of the final implant.  The latter obviously slips into the original osteotomy.  An angled abutment may be needed to correct the trajectory.  Nearly 1 month postop, the 4.5x5.5(5) cementation abutment is loose.  When it is removed, the patient feels pain from the implant.  A 5.5x6 mm healing abutment is placed instead.  The implant osteointegrates with trabecular pattern in the sinus 9 months postop (Fig.20 *).  A 4.5x5.5(4) mm cementation abutment is used with mesial trimming before impression.  The gingival cuff is healthy.

Trajectory Last Next Xin Wei, DDS, PhD, MS 1st edition 05/06/2018, last revision 09/25/2020