Internal or External Sinus Lift?  

A 63-year-old woman wants to change upper RPD (for #2-4, 13 and 14) to implants because of denture-associated candidiasis.  She is afraid of osteoporosis, although the implant at #18 is doing fine almost 3 months post cementation (Fig.1).  One way to restore the upper right quadrant is to place 3 short implants (7.3 or 8.5 mm) with guide with simultaneous internal or external sinus lift (Fig.2-4).  The tooth #12 appears to have root fracture with periradicular radiolucency (Fig.5); an immediate implant will be placed.  While a short implant will be placed at #13, no implant will be placed at #14 because of 1 mm bone (Fig.6).  A cantilever FPD will be fabricated in the upper left quadrant.  The thick left sinus membrane is a problem as related to a lift?

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Xin Wei, DDS, PhD, MS 1st edition 01/11/2019, last revision 02/10/2019