Fig.4: Bone height is limited for implant placement at the sites of the 2nd premolar and the 1st molar (7.68 and 4.45 mm, respectively).  The depth of the pilot drills is controlled between 6 and 8 mm for #13 and less than 6 mm for #14 at the crest. 

Bone expanders are used to form osteotomy and internal sinus lift if bone density is found to be low on pilot drilling.  Expanders are used until 3.0 or 3.4 mm for #13 and 3.8 or 4.3 mm for #14.  A perio or implant explorer is used to check integrity of the apex of the osteotomy.  Allograft and Osteogen will be used for sinus lift.

A 4x14 and 5x11 mm one-piece implants will be placed (apices being pointed (red lines); while abutments being attached (pink lines)). Approximately 4-5 mm implants will stick into the sinus space (but underneath the sinus membrane).  Immediate provisionals are to be splinted without any occlusal contact.

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Xin Wei, DDS, PhD, MS 1st edition 07/19/2013, last revision 07/19/2014