Situation
A 57-year-old female no general disease and no history of allergies or smoking.
The final treatment plan included:
1) the extractions of #13, 15, 17, and 26
2) immediate implant placement at sites #15, 17
3) sinus graft by crestal approach (SCA tech.) at the time of implant placement at #15, 16 and 17
4) Sinus graft by lateral approach (SLA tech.) at #26 and 27
5) GBR and staged (late) implant placement for #13 site
6) Implant placement at #37, 31, 42, 46 and 48
Clinical view on the right side.
Clinical view during the extractions.
After drilling 1mm shorter than the residual bone height, the 3.2mm S-reamer of SCA kit was used 1mm deeper than the prior drilling depth (#17-7mm, #16-5mm, #15-9mm).
The #15 part was perforated at 9mm without damaging the membrane, and EB410 was placed (Class II CMI fixation without bone graft), resulting in good initial stability of 40 Ncm, which is the same as for the #17 area.
Bony particles around the tip of the S-reamer help to perform reaming without damaging the membrane.
CMI Implant EB 508 (external type, Ø5.0×8.5mm) was placed (Class II CMI fixation).
The graft materials are inserted.
Bone graft materials can be spread evenly by using a bone spreader.
The #16 part is elevated about 6mm and the EB 510 implant was placed with insertion torque value of 20 Ncm (Class III CM fixation).
Healing abutments were connected.
Clinical view after wound closure.
Panoramic view after implant placement.
Clinical view after nine months.
Periapical view.
Buccal view for the final prostheses.
Clinical view after final prostheses.
Panoramic view after the delivery of final prostheses.
Clinical view after 7 year follow-up.
Clinical view after 7 year follow-up.
Panoramic view after 7 year follow-up.
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