Staged sonic assisted sinus-lift and ridge graft

Copyright © 2012 Idondivi, Inc. All rights reserved.

Categories; Posterior, Sinus lift, multiple implants, CBCT, Nobel Biocare

2 Copyright © 2012 Idondivi, Inc. All rights reserved

Buccal and lingual defect, sinus pneumatization necessitating ridge grafting and

sinus-lift


Preoperative CBCT, with VPS impression in situ allowing visualization of the soft

tissue thickness


Sonic KAVO handpiece with diamond restorative tip. Abrades hard tissue ( bone),

while not affecting soft tissue (schneiderian membrane)


Lateral sinus access grafting with ceramic material ( unigraft) Non resorbable

titanium reinforced membrane covering DynaBlast putty


Planning two implants


Six months healing.


BLP in position for cement retained crown.


BLP’s in position for two implants


Ideal implant spacing for two premolar crowns


# 12 site, correct image, no need for rotational adjustment, hence using a green

0-degree rotation-block


Flap to allow visualization of grafted ridge, and to position attached tissue on the

buccal


1.5 mm twist drill


BTI motorized expanders


# 12 site, 10 mm x 3.5 ND Nobel Active


# 13 at 7 mm, so OK for 10 mm implant


Additional 3 mm Flexistop for stepped back preparation for tapered implant


# 13 site , 10 x 3.5 NP Nobel Active


Bone-mill


Implants installed per planning


Tissue glue


Implants placed per planning


Attached tissue towards the buccal. Guided surgery does not mean flapless

surgery

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Staged sonic assisted sinus-lift and ridge graft