This case shows how to elevate the maxillary sinus membrane and graft the sinus crestally using the water press membrane elevation technique.
Situation
Pre-op panorama
The treatment plan was as follows:
Sinus graft by crestal approach (SCA tech.) at the time of implant placement at #15 and 17
Intra-oral photograph
Ø 2.2 drill (1200 rpm)
Ø 2.8 drill (1200 rpm)
Ø 3.2 drill (1200 rpm)
Ø 3.7 drill (1200 rpm)
Ø 3.2mm S-reamer (1200 rpm) of the Sinus All kit with 8mm, 9mm, 10mm, 11mm and 12mm stopper were used at the area of #15.
Ø 3.9mm S-reamer (1200 rpm) of the Sinus All kit with 3mm, 5mm, 6mm and 7mm stopper were used at the area of #17.
After serial drilling with twist drills, S-reamers were used with at least 1200 rpm, starting by drilling 1mm less than the depth to the sinus floor, then continuing up to the opening of the inferior wall of the sinus.
The depth gauge was used to detect the opening of the inferior wall and measure the actual bone length.
#1 elevator. One end is designed to detach the membrane at the mesial side and the other end for the distal side.
It is recommended that the membrane is detached at mesial and distal sides first with the #1 elevator.
The same amount of saline as planned for sinus membrane elevation was prepared in the syringe.
An Aqua tap of the SinusAll kit was connected to the drilling site for elevating the sinus membrane with hydraulic pressure.
Aqua valve with saline syringe was linked to the access hole of the firmly fixed Aqua Tap.
The plunger of the syringe was moved forward and backward with attention not to cause the sinus membrane to tear. After elevation, bone graft material was inserted in the usual manner.
Allograft was inserted into the space of the elevated sinus membrane.
Neobiotech IS-III Ø 4.5x10mm fixture was placed in the area of #15.
Neobiotech IS-III Ø 5.5x10mm fixture was placed in the area of #17.
Surrounding bone was trimmed with a bone profile (50rpm).
Healing abutments were placed on the implants.
Panoramic radiograph taken after implant placement.
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