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Francisco Delille

Coimbra, Portugal

Clinical case description:

This technique of implant placement with simultaneous indirect sinus-lift is performed respecting the microsurgical principles using optical magnification.

 

The bone graft and implant placement begins with the usually implant drills until we reach the cortical bone plate on the sinus floor. The cortical bone plate is opened with a piezosurgery round insert exposing the membrane in the same diameter of the implant preparation. After confirming that there is no membrane injury, the Geistlich Bio-Oss® Collagen block is divided in 8 small blocks witch are, one by one, slowly introduced into the implant site and condensed with vertical and lateral pressure detaching the Scheiderian membrane. Then the implant is slowly manually screwed into the bone and into the graft. After three months second stage is performed with healing abutment placement. Two weeks later, impressions are taken and ceramic crown rehabilitation can be achieved.

 

Geistlich Bio-Oss® Collagen allows the membrane elevation without injury and the new bone, after graft consolidation, shows a radiographic appearance very similar to the natural bone.

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<p>Edentation of tooth # 26 with only 4 mm bone height to the maxillary sinus.</p>

Edentation of tooth # 26 with only 4 mm bone height to the maxillary sinus.

<p>Schneiderian membrane exposure with piezosurgery and graft placement: 100mg Geistlich Bio-Oss<sup>®</sup> Collagen block.</p>

Schneiderian membrane exposure with piezosurgery and graft placement: 100mg Geistlich Bio-Oss® Collagen block.

<p>Radiograph after implant placement: bone level 4,8-8mm implant. Membrane elevation and bone graft can be observed.</p>

Radiograph after implant placement: bone level 4,8-8mm implant. Membrane elevation and bone graft can be observed.

<p>10 month control radiograph: the bone graft consolidation shows a bone with the same radiographic appearance as the natural bone.</p>

10 month control radiograph: the bone graft consolidation shows a bone with the same radiographic appearance as the natural bone.

Pre-surgery


							<p>Edentation of tooth # 26 with only 4 mm bone height to the maxillary sinus.</p>

Surgery


							<p>Schneiderian membrane exposure with piezosurgery and graft placement: 100mg Geistlich Bio-Oss<sup>®</sup> Collagen block.</p>

Outcome


							<p>Radiograph after implant placement: bone level 4,8-8mm implant. Membrane elevation and bone graft can be observed.</p>

Follow-up after at least 6 months


							<p>10 month control radiograph: the bone graft consolidation shows a bone with the same radiographic appearance as the natural bone.</p>