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  Open sinus lift with tenting

The opinions within this web page are not ours. Authors have been credited for the individual posts where they are. Photos courtesy Terry Pannkuk - ROOTS
From: Terry Pannkuk
Sent: Tuesday, February 03, 2009 10:24 PM
Subject: [roots] Open sinus lift with tenting

This was my first open sinus lift (Implant #18) almost 3 years ago.  No foo foo.
I simply reflected the Schneiderian membrane enough to create space for blood
pooling as it was tented by the implant which I placed looking at both ends
for ideal placement.  It looked nicely restored with solid integration at the
1 1/2 year recall which is attached. There something to be said by keeping
things simple and adhering to biologic principles.    I'll post a similar
implant case I treated yesterday where I went flapless because I had a bit
more bone - Terry

Terry, great case, nice approach and fantastic result. Thanks for sharing your ideas and experience - Jose Very nice terry. No question creating a space with a clot is all that is necessary. But based on steve wallaceís work at nyu, and he has 9 year follow-ups, and dennis thompsonís work, I still prefer to have volumetric material in place. Here is a recent case where we did a summerís lift using collatape, and the marshmallow technique of mixing pepgen p-15 and p-15 flow. We were able to gain 5mm. fixture is a 5x11.5 osstem gsII. For the record, Iíve had a couple issue of non fitting armamentarium with our good friends from loma linda myself. frankly, I love their torque wrench, but not much else - gary
I hear ya. It pisses me off beyond belief, because my staff works very hard to test all our materials and instruments to make sure everything is perfect before a procedure. To have a company screw the pooch on their quality control at a critical time when you need an instrument or material to be right is just plain inexcusable, especially when they charge you 10 x what the crap should be selling for to begin with. Implant companies in general piss me off; they are essentially greedy "muthas" breeding a culture of greedy "mutha" practitioners who ignore science to drill patients partying at their "Screwfests" not really considering ideal patient care and appropriate selection of treatment options via critical thinking - Terry Terry, here is a sinus lift that I did to perform an apicoectomy on tooth # 13, and at the same time prepare the area of 14 for future implant placement. A piezotome machine was used to open the lateral window, some spoons to elevate the Schneiderian membrane, and the area grafted with Pepgen 15. MTA was used as a retrograde. Amazingly the patient hardly had any swelling, no discomfort. So to a question previously asked, I do perform sinus lift when doing apical surgeries, no always as extensive as this, but I think it is a must to learn how to do, makes your life easier and less afraid of many cases - Jose

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