Wide implant placement in the sinus-lifted maxilla and native bone

Situation

Preoperative radiograph shows 5mm of available bone height on #16

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Flap raising on site 16

Site preparation was done with Ø3.6 S-reamer at 1200rpm.

In the S-reamer drilling, bone chips produced a wide and flat bony surface on the cross-section of the head, which prevents perforation of the sinus Schneiderian membrane.

Taper drill designed for S-wide implant

Site 16 was prepared to place Ø6.0*7.0mm S-wide EB implant.

ф6.0*7.0mm S-wide EB implant in place

Immediate loading was planned due to 45N/cm of excellent stability achieved in the inferior cortical wall.

ф6.0 healing abutment

Class II CMI fixation was achieved with 1-2mm of sinus involvement. The sinus was not grafted.

Panoramic radiograph of implant placement

Pick-up impression coping

One week after implant placement

PFM SCRP crown on the model

Occlusal view

Try-in of the SCRP crown

External type of abutment in place

The final SCRP crown was cemented on the SCRP abutment with a final resin cement.

The crown was unscrewed and polished outside the mouth.

Occlusal view. SCRP type of final restoration was delivered one week after implant placement.

Panoramic radiograph of the final delivery of the crown.

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Conclusion

This case presents replacement of failed implant with ф6.0*7.0mm Neobiotech S-wide EB implant on site 16. Site preparation was done with S-reamer and no grafting was conducted. Implant was placed with 1-2mm of sinus involvement and has achieved inferior cortical fixation with 45N/cm of excellent stability. Immediate loading was performed on the same day of the surgery.