Sinus membrane elevation through the crestal approach

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Patient information

Patient: 66 years old female Chief complaint: "I have been having gum pain since the last dental therapy."

Preoperative observation

Diagnosis

#25 & #26: extraction required after failed endodontic therapies #27: implant placed with sinus graft

Treatment planning

Implant site: Immediate placement on teeth 25 and 26 Surgery date: March 28, 2014 Time for total treatment: 3 months

Both extraction sockets 25 and 26 were carefully debrided with copious saline solution after extractions. Clinical view of socket 26 clearly shows interradicular bony septa.

The center of the interradicular septum of bone was prepared with S-reamer to enable an implant to be placed in the middle of the socket without the membrane tearing.

The remaining bone height was 3mm. Starting from 2mm stopper, the site was drilled 1mm by 1mm until the sinus cavity opened without the membrane tearing.

Occlusal view of the drilling site. Sinus membrane was seen intact.

In a reduced bone height less than 3mm, the maxillary sinus membrane can be elevated using a micro-lateral sinus elevator in the SLA kit through the crestal approach. This is #1 elevator.

#2 elevator. After elevation of the membrane, bone graft was performed with an alloplast (Calpore)

CMI IS-II Active implant 4.5*11mm was placed in the site 25, achieving 30Ncm of insertion torque value.

CMI IS-II Active implant 5.0*8.5mm was placed in the site 26, achieving 30Ncm of insertion torque value.

The gaps between the implants and the bony socket walls were filled with an allogenic bone substitute material (RegenOss).

Healing abutments in place. Ø8.0 wide healing abutment was palced on tooth 26.

Radiograph taken after implant placement.

Clinical view of the implant site after 3 months of healing.

A 3 unit full zirconia SCRP was prefabricated.

Occlusal view.

3 SCRP multi-abutments were connected in the implant 3 months after the surgery.

The 3 unit SCRP full zirconia was cemented on the SCRP multi-abutments and the abutment-prosthesis unit was removed and polished and reinserted in the mouth.

2 years postloading radiograph.