Sinus Graft with Simultaneous Implant Placement via the use of Osseodensification Burs
This is a 72 year old gentleman that I recently saw for placement of 2 maxillary right posterior implants with simultaneous sinus grafting – lateral window approach. I have used the Versah Burs for approximately 10 months now and this is a great example of using Osseodensification to provide excellent implant primary stability.
Figures 1 and 2 show a partially pneumatized maxillary right sinus with approximately 3 mm of residual bone height (RBH) present in the #3 and #4 sites.
Figures 3, 4, 5 show the progressive use of the Versah Burs in a counter clockwise mode to provide osseodensification of the sites. Please note that the sinus membrane is quite visible via the osteotomy sites.
One great advantage of using this bur system is that it allows one to very precisely create implant osteotomies and utilize a crestal approach for sinus grafting in a number of cases that would normally be done with a lateral approach.
In this particular instance with an RBH of 3 mm I used the conventional lateral approach (Fig. 6, 7). You will note in Figure 7 the graft mix of MinerOss and BioOss along with LPRF.
The sinus is grafted and implants are subsequently placed with excellent primary stability (Fig 8, 9).
Next, the graft is completed with lateral condensation and addition of more graft material (Figures 10, 11).
Finally, primary closure is obtained with 3.0 PTFE sutures (Figure 12). In 3 months these implants will be restored.
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