BEFORE & AFTER
After x-ray: Four implants holding a fixed bridge to replace all the missing teeth. The posterior chewing function has been restored. A 12- year result.
The diagram shows adequate bone on one side (A) for some implants vs insufficient or minimal bone under the Sinus cavity in the upper jaw on the opposite side (B).
Preoperative CT Scan
reveals 1-3 millimeters of remaining bone on both the right and left sides of the upper jaw. All the teeth are missing and the patient had been wearing a denture for twenty years. She is a well-controlled diabetic.
The Axial CT scans also revealed a severely resorbed anterior ridge which is too narrow for implant placement in the front of the mouth.
There is not enough bone to place implants without a Sinus Bone Graft
Follow-up 21 Years after the Sinus Bone Graft and placement of a non-removable bridge. The patient is 83 years old now.
Simultaneous Bone Graft and Implant Placement
In other patient situations when there is more bone available, but not quite enough to cover the whole implant (Fig. 6), a bone graft may be done at the same time as the implant placement. This is called Simultaneous Bone Graft and Implant Placement versus the Two-stage delayed approach.
Contraindications for Sinus Elevation (Lift) procedures
Uncontrolled diabetes mellitus
Intranasal or topical steroid use
Maxillary radiation therapy
Unrepaired oroantral fistula
Active acute sinus disease
Chronic septic sinus disease
Inadequate or excessive
Anti-coagulants (blood thinners) that cannot be stopped