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67 year old female. A staged sinus-lift was performed via the crestal approach. After 6 months of healing two implants were planned. Patient has a Class III relationship. The cuspid root is slanted towards the distal. The implants are slanted accordingly to support screw retained crowns with the screw access hole in the central fossa.
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Copyright © 2012 Idondivi, Inc. All rights reserved.
Categories ; Posterior, sinus lift, multiple implants, Nobel Biocare
2 Copyright © 2011 Idondivi, Inc. All rights reserved
Crestal approach sinus lift, not incremental fill with glass ceramic graft ( Unigraft)
3 Copyright © 2011 Idondivi, Inc. All rights reserved
Two implants planned after 6 months healing
4 Copyright © 2011 Idondivi, Inc. All rights reserved
BLP positioned for screw retained restoration.
5 Copyright © 2011 Idondivi, Inc. All rights reserved
Two implants planned, root of cuspid is far distal hence inclination
6 Copyright © 2011 Idondivi, Inc. All rights reserved
Wings removed to allow side by side nesting for two implants
7 Copyright © 2011 Idondivi, Inc. All rights reserved
Guide in place
8 Copyright © 2011 Idondivi, Inc. All rights reserved
Guided surgery does not mean flapless surgery. A flap allows transportation of
keratinized gingiva to the buccal
9 Copyright © 2011 Idondivi, Inc. All rights reserved
Initial setup. Radiograph is diagnostic the buccal and lingual RIR’s overlap
10 Copyright © 2011 Idondivi, Inc. All rights reserved
The red 7 degree RIR allow visualization of a 7 degree rotation
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# 12 yellow rotation-block for 3 degree rotation. 2 mm twist drill for 8.5 mm
osteotomy
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8.5 x NP Nobel Active
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Bonemill
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# 13 site, 7 mm osteotomy. Red rotation-block gives 7 degree rotation
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7 mm osteotomy
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Motorized BTI expanders for sinus bump if needed
17 Copyright © 2011 Idondivi, Inc. All rights reserved
Motorized BTI expander
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8.5 x ND Nobel Active implant
19 Copyright © 2011 Idondivi, Inc. All rights reserved
Attached tissue moved towards the buccal
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Two implants placed as planned