Bilateral Maxillary Sinus LiftBilateral Maxillary Sinus Lift

Right side is planned as a staged Right side is planned as a staged sinus lift procedure with the surgical sinus lift procedure with the surgical removal of the second bicuspidremoval of the second bicuspid

Left side planned for sectioning of Left side planned for sectioning of fixed bridge, removal of fractured fixed bridge, removal of fractured premolar, left antral graft and premolar, left antral graft and immediate placement of three immediate placement of three osseointegrated tapered screw vent osseointegrated tapered screw vent implants implants

First Surgical Procedure: Right First Surgical Procedure: Right SideSide

This is a 40 year old patient This is a 40 year old patient scheduled for prosthetic scheduled for prosthetic reconstruction of maxillary reconstruction of maxillary archarch

Opposing fixed mandibular Opposing fixed mandibular bridge workbridge work

No posterior maxillary No posterior maxillary dentitiondentition

Our goal was to place 2, long, Our goal was to place 2, long, tapered screw vent implants tapered screw vent implants on the right side (13mm)on the right side (13mm)

Implant length is important in Implant length is important in younger patients to insure younger patients to insure long term, proper function long term, proper function against opposing fixed against opposing fixed bridgework bridgework

Staged Sinus LiftStaged Sinus Lift

The right side was The right side was staged due to the lack staged due to the lack of bone and the desire of bone and the desire to augment the right to augment the right antrum with 8-10mm antrum with 8-10mm of boneof bone

As with all of our bone As with all of our bone grafting procedures, grafting procedures, the grafts are the grafts are augmented using augmented using platelet concentrateplatelet concentrate

Second Surgery: bilateral Second Surgery: bilateral procedureprocedure

2 tapered screw vent implants are 2 tapered screw vent implants are placed into the right antral graftplaced into the right antral graft

On the left side we sectioned the On the left side we sectioned the fixed bridge distil to the maxillary fixed bridge distil to the maxillary left canineleft canine

The left first bicuspid was The left first bicuspid was surgically removedsurgically removed

3 tapered screw vent implants 3 tapered screw vent implants were placed in the left quadrantwere placed in the left quadrant

The anterior implant was The anterior implant was immediately placed in the immediately placed in the extraction site of the first bicuspidextraction site of the first bicuspid

An antral sinus lift was performed An antral sinus lift was performed on the left side for the posterior on the left side for the posterior implantimplant

11.5mm implant placed 11.5mm implant placed immediately into left antral graftimmediately into left antral graft

Surgical NotesSurgical Notes Notice complete Notice complete

osseous healing of osseous healing of buccal window 4 buccal window 4 months after staged months after staged antral graft on the antral graft on the right sideright side

The right sinus lift The right sinus lift graft enabled the graft enabled the placement of a 4.7, placement of a 4.7, 13mm & 3.7, 13mm 13mm & 3.7, 13mm implants into the implants into the second bicuspid and second bicuspid and first molar sitesfirst molar sites

Surgical NotesSurgical Notes Note buccal defect Note buccal defect

associated with anterior associated with anterior implant placed implant placed immediately into the first immediately into the first bicuspid extraction sitebicuspid extraction site

Sinus window and Sinus window and schneiderian membrane schneiderian membrane visible with parallel pin in visible with parallel pin in distil implant sitedistil implant site

Graft applied to left antrum Graft applied to left antrum as well as buccal defectas well as buccal defect

Note the neat isolation and Note the neat isolation and containment of graft containment of graft material due to the use of material due to the use of platelet rich plasmaplatelet rich plasma

Final NotesFinal Notes Note radiopaque areas Note radiopaque areas

in the right and left in the right and left sinus cavities sinus cavities indicating organization indicating organization and ossification of and ossification of sinus graftssinus grafts

This patient was This patient was treated in 2 efficiently treated in 2 efficiently planned surgical planned surgical procedures with the procedures with the aid of general aid of general anesthesiaanesthesia