Flapless sinus crestal bone graft and implant placement

허영구 원장님 Dr. Heo

Author
Dr. Young-Ku Heo, DDS, MDS, PhD

Director of Global Academy of Osseointegration
Seoul, Korea



Patient: 49 years old male
Medical history: Hepa B, HBP
Dental history: #24, #25, #26 & #27 extracted earlier at another clinic
Chief complaint: "I want to replace my missing teeth."
- Teeth missing on #24, #25, #26 & #27
- Pneumatization of the maxillary sinus
Crestal bone augmentation on the maxillary left quadrant using the water press membrane elevation technique and simultaneous implants placement on # 24, #25 & #26
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The excision on the attached gingiva was made using the tissue-punch technique.

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The inferior cortical wall of the sinus was prepared using S-reamer in the SCA Kit after 1mm shorter and one step narrower drilling. Drilling with the S-reamer was continued until the inferior cortical wall of the sinus opened without the membrane tearing.

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The sinus membrane around the hole was elevated through the crestal approach using a rotary elevator in the Sinus All Kit. The elevator should be carefully and slowly rotated by manual without a stopper.

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Aqua tap was inserted by manual into the drilled site.

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The connector was connected into the head of the tap and about 0.7cc of saline solution was slowly injected by detecting the injection pressure.

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The sinus was grafted with an alloplast (Calpore) using a bone carrier.

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Three IS ll active implants were placed with 40Ncm of insertion torque values.

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Healing abutments were placed on the implants.

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Panoramic radiograph taken after implant placement. The maxillary sinus was successfully elevated and grafted.

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Impression was made using the "PickCap" impression coping system 3 months after placement.

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Final restorations were delievered.

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Postloading radiograph right after the delivery.

A 49-year-old male patient was referred to the clinic for implant therapy of his left maxilla. This case shows how to elevate the maxillary sinus membrane and graft the sinus crestally using the water press membrane elevation technique.

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