This is a very unique case where a large sinus bone graft had to be performed for just one dental implant. This example below was done at my office in Burbank.
The sinus was so expanded from bone loss that an “internal sinus bone graft” would not work. There was not enough pre-existing bone to do that technique which reduces cost and time.
On a side note, many patients mistake the word “graph” with “graft.” “Graft” is the proper term for “grafting” bone or tissue such as gums or skin.
Here is how he started with one missing tooth and no bone in the area. This is a hollow sinus in the area of the upper left first molar #14:
This is what the sinus looks like from the inside from the CT scan. Double click to enlarge the image.
My virtual surgical planning software allows me to do surgery on the computer before the real dental implant or bone grafting procedure.
The purple object is the dental implant plan and the red drawing is how much bone is missing. That is a lot of missing bone!
Here is the x-ray after the bone graft. The implant is 16mm long and there is still bone beyond it. I was able to build about an inch and a half of bone for this patient!
It was allowed to heal for 4 months.
When you look closely at the implant near the top, you can see that the bone is dense near the neck. Now he can put the tooth on the implant!
Can you see the bone growth? Feel free to comment below. No need to sign up!
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com
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Based on the type of CT scan above,if a patient presented to you with some mild or moderate chronic thickening or air-fluid in their maxillary sinus but were otherwise asymptomatic would you still place implants in the upper molars?
Jim
Hi Jim,
I assume you are a dentist.
It depends on the patient and their history.
Ramsey A. Amin, D.D.S., D.A.B.O.I.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Hi Dr. Amin,
I am actually a patient and not a dentist. I actually had a dental ct of my upper right molar area which showed some “mild” air fluid level. This was done three years ago in anticipation of doing an implant in #3 tooth. I did not continue with the implant because of cost, but I am considering it now. The ENT doctor I subsequently saw said it was chronic sinusitis although i have no chronic symptoms.
Hi Jim,
Generally a sinus without symptoms; even with mild thickening would probably be ok. I have treated hundreds of sinuses like yours in my office in Burbank.
The technique of handling a membrane like yours is a bit different though.
Do you need an internal sinus lift or a lateral window sinus graft? Are you missing teeth in front or behind the area? Are there any other dental implants in the area?
Ramsey A. Amin, D.D.S., D.A.B.O.I.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Hi Dr. Amin,
I actually have tooth #3/#2 missing and I wear a partial. I would at least like to replace the first molar spot. I am very much considering implants but I am worried that an implant specialist will not take my case because of my sinus thickening(with no symptoms). I think I had 8mm of thickening in height in the maxillary sinus on CT.
sorry for not addressing your questions. I did have a bone graft at extraction time which I believe was a synthetic graft. Also there are no other implants in my mouth. Can implants be placed one after another, so #3 gets an implant and #2 gets one as well?
Hi Jim,
Yes, implants can be placed right next to each other at the same time or in stages over time. It is better to place them at the same time though.
The thickened membrane may pose as an ADVANTAGE. After I see you and your CT I can tell you if this will be the case.
If you live close enough, you are welcome to see me as a patient.
Respectfully,
Ramsey A. Amin, D.D.S., D.A.B.O.I.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry