A short implant is planned so that the sinus floor is not violated (Fig.4).  We want to test whether primary stability is achievable.

After extraction, osteotomy is initiated in the middle of the septum (Fig.5 between the mesiobuccal (MB), distobuccal (DB) and palatal (P) sockets) and underprepared.  The top of the septum is pointed.  A high speed hand piece bur is used to flatten the septum before using a 2 mm pilot drill (800 RPM) to start the osteotomy.  The depth of the osteotomy increases (from 8 to 11 mm) as the diameter of the pilot drill and reamers increases (2.5-3.5 mm).  The speed of the reamers is 50 RPM.  In case of sinus floor penetration, the sinus membrane may be elevated without tearing.  The integrity of the membrane is tested after each step.

Shorter Maxillary Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 07/04/2015, last revision 07/04/2015