Australasian Dentist Implant Dentistry Today No 15

Implant Dentistry Today 18 2. Closed sinus lift with placement of two implants 3. Placement of two fully tapered short implants The selected treatment plan took into account the patient’s age, medical conditions and expectations. Taking these three points and the patient’s wishes into consideration, we decided to go for option number 3. Many studies have shown short implants to be as predictable as standard implants 6-7, and this was one of the main reasons why we considered this option as the best for this patient, when bearing in mind a patient-centered solution with less invasive procedures. In this patient, the decision to use short implants was very important because it allowed us to perform a less invasive surgery. Performing a sinus lift procedure would have exposed us to an increased risk of postoperative bleeding. urgi a ro edure The patient underwent local infiltration anesthesia (lidocaine 2% with epinephrine 1:100.000), in the area corresponding to the apex of #25 and the molars of the second quadrant (Fig. 8). Intrasulcular, supracrestal, and distal releasing incisions were performed with a no. 15 blade (Figs. 9, 10). A full-thickness flap was then raised in order to gain access to the bone and evaluate the anatomy of the treated area (Fig. 11). Based on the wax-up, a surgical stent was prepared in order to guide a prosthetically driven placement of the implants (Fig. 12). Following the flap elevation, the stability of this guide was verified (Fig. 13). A medium quality bone protocol was followed to prepare the implant beds. Since we were placing a ø 4.5 mm implant, the ø 3.7 mm drill was the last one to be used. The drilling protocol started with the use of the needle drill (ø 1.6 mm), followed by the pilot drill/drill no. 1 (ø 2.2 mm), drill no. 2 (ø 2.8 mm), drill no. 3 (ø 3.2 mm), drill no. 4 (ø 3.5 mm) and, finally, drill no. 5 (ø 3.7 mm). Each drill was used under copious irrigation, and the tip was moved back and forth in order to avoid overheating (Figs. 14-19). In accordance with the choice made during the treatment planning, a Straumann® BLX with 4.5 mm diameter and 6 mm length SLActive was used (Fig. 20). The implant was taken from the vial and removed with a slight clockwise turn (Fig. 21). Finally, it was placed on the prepared implant bed at position #25 (Fig. 22). The same procedure was applied for implant #27 (Fig. 23). Next, both healing abutments were placed (GH 2.5 mm, ø 4.0 mm) and an optimal amount of buccal bone was observed on both implants (> 2 mm) (Fig. 24). Finally, the flaps were closed by the placement of interrupted sutures with Vicryl 5/0 (Fig. 25). A postoperative radiograph showed an optimal vertical location of the two 6 mm implants. Furthermore, the maxillary sinus was not invaded, and both implants were in parallel alignment thanks to the drilling guide (Fig. 26). After one week, the patient attended Fig 7 Fig 8 Fig 9 Fig 10 Fig 11 Fig 12 Fig 13 Fig 16 Fig 14 Fig 17 Fig 15 Fig 18