Sinus membrane elevation through the crestal approach

허영구 원장님 Dr. Heo

Dr. Young-Ku Heo
DDS, MDS, PhD

Director of Global Academy of Osseointegration
Seoul, Korea



Patient: 66 years old female
Chief complaint: "I have been having gum pain since the last dental therapy."
#25 & #26: extraction required after failed endodontic therapies
#27: implant placed with sinus graft
Implant site: Immediate placement on teeth 25 and 26
Surgery date: March 28, 2014
Time for total treatment: 3 months
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Both extraction sockets 25 and 26 were carefully debrided with copious saline solution after extractions. Clinical view of socket 26 clearly shows interradicular bony septa.

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The center of the interradicular septum of bone was prepared with S-reamer to enable an implant to be placed in the middle of the socket without the membrane tearing.

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The remaining bone height was 3mm. Starting from 2mm stopper, the site was drilled 1mm by 1mm until the sinus cavity opened without the membrane tearing.

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Occlusal view of the drilling site. Sinus membrane was seen intact.

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In a reduced bone height less than 3mm, the maxillary sinus membrane can be elevated using a micro-lateral sinus elevator in the SLA kit through the crestal approach. This is #1 elevator.

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#2 elevator. After elevation of the membrane, bone graft was performed with an alloplast (Calpore)

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CMI IS-II Active implant 4.5*11mm was placed in the site 25, achieving 30Ncm of insertion torque value.

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CMI IS-II Active implant 5.0*8.5mm was placed in the site 26, achieving 30Ncm of insertion torque value.

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The gaps between the implants and the bony socket walls were filled with an allogenic bone substitute material (RegenOss).

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Healing abutments in place. Ø8.0 wide healing abutment was palced on tooth 26.

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Radiograph taken after implant placement.

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Clinical view of the implant site after 3 months of healing.

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A 3 unit full zirconia SCRP was prefabricated.

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Occlusal view.

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3 SCRP multi-abutments were connected in the implant 3 months after the surgery.

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The 3 unit SCRP full zirconia was cemented on the SCRP multi-abutments and the abutment-prosthesis unit was removed and polished and reinserted in the mouth.

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2 years postloading radiograph.

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