Sinus lift : implant case : maxillary posterior : osteotomes

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 Sinus lift

The opinions  within this web page are not ours.Authors have been credited  for the individual posts
where they are. - www.rximplants.com  photographs courtesy: Artura
From: Arturo R. Garcia
Sent: Fri 12/29/2006 19:09
To: IMPLANTS ONLINE... @rximplants.com
Subject: [implants] sinus lifts

Here is a flapless, guided implant case I did yesterday which involved 3 implants and bi lateral sinus lifts
in the maxillary  posterior.  I used osteotomes to fracture the sinus floor and a balloon to lift the
membrane on the right side.  I did not use the balloon on the upper left- I think I should have.  Patient
did well. Placed 3- 4.5 x 11 Ankylos implants and used cancellous bone with some bone gen mixed in.

Total clinical time was 2 hours plus about 10- 20 minutes of computer time with CT scans and coDiagnostiX
virtual treatment planning software.

This patient had been seen by two other dentists over the last two years to evaluate the same areas for
implants. Both dentists had told him he would need a two stage surgery.  First grafting and 6 moths healing
time followed by fixture placement and an additional 6 months of healing time.  both surgeries used flaps and
the grafting used lateral windows.  There’s nothing wrong with what he was told, it would have worked.  But I
definitely saved him at least 6 months on treatment time, two flap surgeries and thousands of dollars.
And I was still very well paid for my efforts.

IMO the combination of CT scans, coDiagnostiX virtual treatment planning software and surgical guides makes
these cases smooth. I was happy with the result but in the future when I have a balloon out to lift the
membrane I will use it on both sides J. - Arturo

Arturo, what is the outcome difference between the type of procedure the pt had been recommended
(grafting and waiting 6 months, in two appointments) and what you performed (placing implants and using
cancellous bone with some bone gen mixed in, in one appointment)? - JLMA, implants illeterate , Marcos

Hi JL, If the fixtures are stable when placed (meaning they do not “spin” in the osteotomy and you
have at least 4 mm of existing vertical, 6 to 8 mm horizontal bone before the graft) they should work
out just as well. The main criteria for case selection for this type of one step surgery is having
enough bone to stabilize the fixture. - Arturo

Yes indeed excellent! Congratulations! - Liviu

Aturo it looks great if you can briefly describe your protocol - John Coetsee

How awesome is that Arturo........do you use the scope to place the implants, how about the sinus lifts......

Tell me about the CT scan and the coDiagnostix virtual treatment planning software as the images are some
of the best I have seen. I really love the case......WONDERFUL. - Glenn

Hey Glenn, Yes I do use the scope for the surgery. Low power typically (full arch or quad view)
supplanted with occasional use of 5X loupes.

The CT scan comes from i-CAT CBCT unit. I have actually started a mobile imaging business and sell
CT imaging to other dentists in my area as well as implant services. I have attached a picture of my
mobile CT unit. Remember, the only thing that happens in the van is CT imaging.

I too am infatuated with the quality images available from this CT scanner. They are just crystal clear
compared to what I have seen over the last few years. And so easy to access for me J!

Anyhow, IMO the use of CT scans, virtual treatment planning software and the resultant precision
surgical guides is bringing implantology into a new era of accessibility, predictability, cost efficiency,
ease and comfort for both the doctor and patient. I do have a vested interest in selling CT imaging to
dentists in my geographic area (with in a 2 hour drive from my office) otherwise I do not have any
financial ties to any of the software or other equipment I use. I use because it works well and while
there are other models and types this is the on I think is best now.

I love playing this game. Glenn, if you want to play too I will be happy to show you how J. - Arturo