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The staged approach on atrophic ridge on the posterior maxilla using Neobiotech IS-II active fixture

A 45 years old male patient, who had missing posterior teeth, presented with a partially edentulous maxilla. Implants placement on #13,#14,#15 and #16 following lateral sinus augmentation was planned…


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Patient information

Male 45 yrs old Non-contributory NKDA Drink occasionally, smoke 1 pack a day

PDH

Scaling and subgingival curettage PFM bridge on #23,24-26 Implant placement on #32, 36, 37, 42 Extraction on #13,14,15,16


Diagnosis & Treatment Plan

Generalized severe chronic periodontitis Treatment plan Scaling and subgingival curettage Sinus augmentation using xenograft Implant placement on #13,14,15,16

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Panorama taken at the initial visit severe vertical bone resorption has been appreciated on the right posterior maxilla

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Occlusal view of the surgical site before sinus augmentation

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Sinus window preparation with the help of piezoelectric devices

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Sinus augmentation has been performed with the use of xenograft(porcine origin)and resorbable membrane.

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Single interrupted suture has been done to adapt the buccal and lingual flaps.

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Panorama taken six months after sinus augmentation before implant placement. The augmented bone can be easily appreciated.

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Occlusal view of the surgical site taken just before implant surgery.

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The implant placement has been done on #13,14,15,16 using Neobiotech IS-II active fixtures. Fixture direction pins have been placed to check occlusal relationship.

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The thin buccal bone on #13,14 area can be easily appreciated.

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Allograft has been placed on the thin buccal bone area together with resorbable membrane.

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Single interrupted suture has been done to adapt the buccal and palatal flaps with one horizontal mattress suture holding the resorbable membrane underneath the flaps.

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4 months after implant placement procedure

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Thick buccal bone can be appreciated at the augmented site around implants.

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Healing abutments have been placed. Palacci technique has been applied to approximate the buccal and palatal flaps.

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Stable healing around the healing abutments can be appreciated.

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Two pieces of splint SCRP zirconia implant prosthesis have been fabricated and cemented with Fujicem.

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Panorama taken after final prosthesis insertion

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