|
|
The opinions and photographs within this web page are not ours. Authors have been credited for the individual posts where they are. - www.rxroots.com |
From: Jose Sent: Thursday, April 02, 2009 8:19 PM To: ROOTS Subject: Re: [roots] Fwd: sinus lift lateral window This is a patient that came to my practice for consultation on dental implants. This will just reflect the impact that your training has on your practice when you incorporate implantology into it. Word goes around of the work and way that you treat your patients, so why should we limit ourselves to simple single tooth cases when down the road you are going to be learning all the principles of grafting and implant placement. As you can see there is not enough bone to do a sinus lift using Summer's technique either one or two stage, not enough bone to get stability on the implant placement, so the only alternative is to do a lateral window, elevate the membrane, and graft the sinus. Wait a period of 8 to 9 month and then place the implants. You can see the pre- op site, the demarcation of the window using a piezotome (EMS), how the window is being elevated, a membrane over the roof of the sinus, grafting the sinus, membrane over the window, and the suturing. Finally you can compare the pre-op and post-op films. on the post-op film you can depict the piece of bone that was pushed into the sinus. - Jose
Jose, I may have placed the window closer to the floor of the sinus and made the window larger for better access to lift the membrane - Dan Shalkey Dan, I understand that it seems to be easier but you need at least 5mm from the floor of the sinus to the bottom part of the window so that it helps to keep the graft in place, in the anterior you cannot extend the window past the anterior border of the sinus, check the pre-op film. Could I have done the window a little bit bigger? probably, but I also take into account the musculature of the cheek - Jose I would have also dealt with the huge amount of recession on the teeth anterior to the sinus lift. Any plan for that? - Dan Shalkey Yes, told the patient that endos are needed and then post and crowns. Since it is going to take at least 8 month for the sinus graft to heal, that is why I started with that now, so that while it is healing we can work on the rest - Jose Dear Dr Jose why would you graft take 8 months to heal against the usual 8 months? I am curious to know. - Sanjay Jamde Dear Sanjay, In terms of the grafting taking 8 month to heal it has to do with the amount of grafting that has been placed, around 2.5 cc to 3 cc of grafting materail, I want to make sure that when I go in for the implant placement the material has turn into bone. Hope this clarifies things - Jose Ok Jose I meant 4 months. I thought the turn over rate was independent of volume. Now I know - Sanjay
