Short Implant Placed Deep
As planned, #15 blade is used for incision and initiation of bone condensation. In fact the bone density is high. Sinus Master kit is used for elevation from 8 mm to 11 mm (from gingiva). The 3.6 mm round bur has to be used (because of dense bone) prior to insertion of a 4.5x14 mm tap (Fig.1: 2-3 mm above the lower sinus floor (^)). A 5x14 mm tap is placed before placement of a 5x8.5 mm bone-level implant (Fig.2). It appears that the implant is placed 2.7 mm above the crest (^).
Effort is exerted to back up the implant without success due to clinical misjudgment (Fig.3). A healing abutment is placed (H: 6.5x5(3) mm). Autogenous bone harvested from the round burs is mixed with Osteogen for sinus lift (*). Deep placement of the implant is a foundation for prevention of periimplantitis. Short implant reduces the chance of sinus membrane perforation.
The sinus floor becomes indistinct 4 months postop, suggesting the elevation of the sinus periosteum (Fig.4). A 5.5x4(3) mm cemented abutment is placed for final restoration.
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#30
Xin Wei, DDS, PhD, MS 1st edition 03/25/2016, last revision 01/07/2018