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Maxillary Sinus Lift
Upper left 2nd molar had been missing for several years, leaving it with short bone height of about 4mm. Crestal-approach maxillary sinus lift and bone augmentation were performed with an initial insertion stability. After 7-8 months of osseointegration of the implant fixture, the final restoration was delivered.
Two-phase implant surgery was performed for this case. In the first phase, missing upper left 2nd molar site was initially grafted with Maxillary sinus augmentation to obtain desired bone height. Then, in the second phase, implant placement surgery was done which was restored with an implant-supported crown after about 6 months.
Surgical implant placement was performed simultaneously with Crestal sinus lift using an osseodensification technique on the missing upper 1st premolar area. A healing abutment was placed, eliminating the need for a second surgery in the future.
Symptomatic, periodontally & endodontically compromised upper premolars and lower 1st molar were extracted, then, maxillary sinus lift for Tooth #4, three immediate surgical implant placements with bone augmentation were performed in a single visit.
Maxillary arch often presents short alveolar bone height, especially if a patient has been missing posterior for many years or having chronic abscess around the area.
Remaining vertical bone height was about 3mm, therefore, sinus lift was performed to gain more bone height as seen on the postoperative CBCT above.
Fractured endodontically treated upper 2nd molar was hopeless and extracted followed by bone graft with membrane. After 4 months of bone healing, implant was placed with sinus lift using an osseodensification method since the remaining bone height was about 6-7mm. Adjacent 3rd molar had to be considered when drilling for osteotomy because of its close proximity to the drilling site (patient did not wish to extract it prior to implant surgery).
Patient presented with the grafted site on upper 1st Molar. Remaining bone height was about 7mm on the CBCT scan. Implant was placed slightly above the sinus floor with good initial stability, which was then restored with abutment & crown.
After 1st molar extraction and initial bone graft, the area was left to heal. Then, after a few months, maxillary crestal sinus lift and vertical bone augmentation on both 1st and 2nd molar regions were performed with two implants placement. They were restored after about 6-7 months of osseointegration.
Due to chronic periodontal disease, the upper 1st molar was extracted and initially grafted. Then, two implants with crestal sinus lift (about 3-4 mm of vertical lift) and bone augmentation were placed In the maxillary arch. One implant on 2nd molar region of the mandibular arch was also surgically placed on the same appointment.
Tooth #13 was extracted due to root decay, together with the pontic crown on #14. A sinus floor above Tooth #13 was perforated during the extraction, and crestal sinus lift for only Tooth #14 region was done using hydraulic pressure with saline. The CBCT confirmed the successful sinus floor elevation.
Upper 2nd molar had a cervical cavity close to its alveolar bone level (hopeless prognosis), so it was initially extracted and grafted. Revisiting the site, implant was placed with crestal sinus lift and vertical bone augmentation.
Periodontally hopeless maxillary 2nd premolar was extracted, and implant was placed with crestal sinus lift with bone augmentation (50/50 Xenograft & Allograft). It was restored after about 6 months of osseointegration.