Planning for Sinus Graft and Immediate Implants with Limited Height

A 56-year-old lady lives out of state.  She requests implant treatment for the upper right quadrants.  Implants were removed by her previous care provider due to pain and infection.  The premolars (Fig.1: #4,5) are provisionalized with a mini-implant (*).  CBCT scans (Fig.1,2 (sagittal sections); Fig.3-6 (coronal section) show limited bone height involving the sites of the teeth #2 (Fig.1,3), 3 (Fig.2,4) and 4 (Fig.1,5).   The buccolingual width is narrow at the sites of the teeth #4 and 5 (Fig.5,6). 

Our experience demonstrates that a single implant can be placed at the site with bone height ~ 3 mm with primary stability.  Since the patient lives far,  immediate implants may be beneficial.  If primary stability is questionable for individual implants, the implants can be splinted by immediate provisionals.

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Xin Wei, DDS, PhD, MS 1st edition 05/30/2014, last revision 05/30/2014