Upper Molar/Internal Sinus Lift 3-D Scan Real Time Dental Implant Before and After Planning Video –Narrated by Ramsey Amin DDS

In the short video you will be able to get a sample of the awesome power of 3D planning for a dental implant and simultaneous internal sinus lift bone graft. You will see all the details that go into planning for a single tooth dental implant that happens to be more complex in nature.  If you have lost an upper molar, this video will be very helpful for you to understand and actually see the relationship of the sinus to the teeth. I show the plan workup through my eyes then I show you the immediate result.  This really helps to understand the process of a single tooth dental implant to replace an upper molar where the sinus is very low.

Internal sinus lift dental implant x-rayThe bone graft used here was a combination of platelet rich fibrin (PRF) cow bone and human bone.  A computer generated guide was not used on this case. As of 2014 I believe that virtual planning should be done for all dental implants.  This technology is way too powerful to skip or just use regular x-rays.  It allows for both the patient and the Dr. to understand your unique situation and adds a tremendous degree of accuracy and safety to your dental implant procedure.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry


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24 thoughts on “Upper Molar/Internal Sinus Lift 3-D Scan Real Time Dental Implant Before and After Planning Video –Narrated by Ramsey Amin DDS

  1. Elleanor Leonard

    Hello, I had 14 removed 3 months ago. The area had a lot of “mush” so was cleaned out the sinus hole got a plug and then collagen filled the area. No bone was put in. I just had a scan and so far no bone has formed. The doctor said give it 6 more weeks and maybe some bone will mineralize. I don’t feel hopeful. He would prefer 3 mill of bone for an implant. If I get this, I will then have a lift and bone put in plus the implant most likely placed at the same time. Does all of this sound like the correct protacal? If little or no bone forms in the next 6 weeks would you recommend a bridge? Chance of an implant failing too high if add bone since not much to start with? Have you seen this situation before? Would you have put bone in when the tooth was taken out or did the sinus need to heal before bone placed? Thank you!

    Reply
    1. RamseyAminDDS Post author

      I have seen this many times before. No bone is likely to form with the technique you have described. I would just have a good lateral window sinus graft so that you can have more than adequate bone for a long lasting implant. If the bone is only 3mm, you will need the bigger sinus I have described.
      Make sure you are being seen by an experienced dentist. Good luck!!

      Reply
      1. Elleanor Leonard

        Thank you so much for your reply! I am a bit confused. I think you are saying in 6 weeks I probably still will not form any bone…I assume since the doctor didn’t put any in. This makes sense. I wish bone had been put in when the tooth was removed. I am at a new periodontist now. What do I do if I have no or minimal at best bone in 6 weeks? Is it smarter for me to get a bridge or do you think I still have a good chance of an implant if a graft and lift are done even though starting with nothing there? I don’t want to get one if the odds are low of success. I get the feeling my periodontist thinks if at least 3 mill is not there which is highly unlikely it will be there, I should get a bridge. He teaches all around the world and has an excellent reputation so I assume he is a good doctor. Apparently, I have a high sinus but since have had so much bone loss I would need a sinus lift with the bone graft. Maybe he thinks success chances are low if starting with zero bone and small space which makes the need for a lift too. Also, where the tooth was pulled my gum is really high which would make for a really long implant. It quite a bit above where the gum hit on the teeth next to it. This is because of the bone loss. As much as I want an implant, I need to be realistic about my situation. I appreciate any further feedback you have. Thank you!!

        Reply
        1. RamseyAminDDS Post author

          Just have a t al sinus lift now. It is really a very predictable procedure even in the presence of minimal to no bone. I do this all the time!!

          Reply
  2. Dale Zale

    I am having a right sinus graft and 3 implants 2,4,5 I do not do well with iv sedation even with anti nausea meds I still throw up afterwards. If I am relaxed and do not move during the 2 hour procedure is it necessary I be sedated? I have had a lot of dental work and tolerate it well with out sedation. I will take 10 mg of Valium before the procedure.

    Reply
    1. RamseyAminDDS Post author

      Don’t take the Valium without your DDS knowing. Thy can cause a serious problem. Some sinus lifts can be pretty intense. Hopefully in the IV you’re receiving an intravenous steroid which will help you tremendously. In the event I have a patient like you that has nausea I simply eliminate the main drug that causes the nausea. Most of the time that would be due to the narcotic such as fentanyl.
      Precedex is a great drug along with a Valium like medicine via IV. Hopefully they are already going into your vein for PRF and or PRP to help your bone graft work.
      Hope this helps.

      Reply
      1. Dale Zale

        When I got to the appointment today I decided to not do any sedation or Valium, I just did not risk throwing up like I have in the past with IV sedation even with anti nausea meds. The procedure started around 12:20 and was completed at 1:50. It was painful at times but I got threw it. Home now doing the ice pack. I will do a floor up in a few days here to let others know how I am feeling.
        I appreciate Dr Ramsey you answering patients questions it really does help!

        Reply
  3. Elleanor Leonard

    Hello, Thank you for all the helpful information you provide. I had a toothache in a tooth that had an old crown over a route canal that was replaced a year ago. I think #14. Long story short I had a 3D scan which showed all the bone around the tooth gone and the membrane of the sinus gone with a big infection. Apparently it had to have been going on for some time. I have had zero symptoms until the tooth hurt last week. No air between teeth and mouth, no pain or drainage or any other symptoms I read I should have if I have this huge hole. The periodontist pulled the tooth, cleaned things out and put in a collegen ban aide and filled with collegen and a plug. No bone graft as he said membrane needs to heal first. I am to wait 4 months to see if heals and if some bone grows. Then get another 3D scan to see if implant possible or bridge. He thinks I have a slim chance of getting a bone gaft, sinus lift and implant since hole is so big and such bone loss. The teeth on either side seem fine. Does this sound like normal procedure? I have never heard of anyone who has had an infection eat all the bone and the sinus membrane especially with zero symptoms. Will the membrane grow back? What happens if it doesn’t? Is it ok to work out the next four months? I am an active person and it will be hard to not workout for a slim chance of not getting an implant. Thank you!

    Reply
    1. RamseyAminDDS Post author

      I would not limit little my lifestyle either. Exercise is a good thing!

      Generally speaking, the sinus will clear itself, the membrane will repair and an implant with the sinus graft is definitely possible. I have treated 100s of patients that had pre-existing holes/perforations or even fistulas into the sinus with sinus bone grafting and dental implants.

      Your surgeon has to be comfortable opening the area and having a pre-existing hole to deal with. If they are not that I would suggest you find someone else.

      Reply
  4. Nina Gurevich

    Dear dr Amin, this is a second post. The first one somehow disappeared. I am legally blind and it is very hard for me to type. After removal of the bridge I have three missing teeth-##2,3,4 in the upper jaw. Graft was done on#3 at the time of extraction – 11 weeks ago. After that I had 3d scan done. I need a sinus lift Also #1 has to be extracted
    My doctor recommends to do the extraction, sinus lift and ##2,3 implants at the same time. Can it be done this way ? # 4 will be taking care of later because of limited funds.
    The procedure is on01/4/2017. Thank you for your time.

    Reply
    1. RamseyAminDDS Post author

      Yes it can be done this way but ideally the other tooth would be implanted at the same time. This would make for more perfect alignment and spacing.

      Sounds like you are seeing somebody who is very experienced.

      I prefer the graft that you had healed for longer than just 12 weeks but I don’t know your exact circumstances.

      Reply
  5. NINA

    hi, dr Amin. After removal of the bridge because of erupted tooth I am missing 3 teeth in the upper jaw: #2,3,4 The#1 is going to be extracted. After removal of the erupted#3 bone grafting was done. 3d scan was done I need a sinus lift. My doctor suggested to do everything at once: #1 removal, sinus lift for#3 and implants for #2 and #3.
    #4 will be taken care of later because of limited funds. Is it a right approach. The procedure is scheduled for January 4/2017.
    Your reply will be greatly appreciated.

    Reply
    1. RamseyAminDDS Post author

      somehow your comment Picked up in the spam filter. I hope everything went smoothly. This sounds like a decent treatment plan. How do it all worked out?

      Reply
  6. Zeny Terhune

    Hi Dr. Amin,
    My molar tooth #14 need to be extracted & I’m thinking of implant on the same day of extraction, will I have a sinus lift? My # 3 upper molar has been removed 4 months ago, how long can I wait for in implant to avoid sinus left?
    Thank you for all the information you have posted in your site, very interesting & informative. I’m still reading & watching the videos. I may have more questions.

    Zeny

    Reply
    1. RamseyAminDDS Post author

      looks like you found the post that I was mentioning to you. Implants for upper molars on the same day are technically difficult and are typically done by a very experienced dental implant provider. There is significant risk of failure and sinus perforation. A sinus lift may or may not be avoidable. This depends on your anatomy. I would suggest a minimum length for a dental implant in this area to be 10 mm for most situations. Trying to undersize and use a small implant will result in bone loss called peri-implantitis. This is because the bone is very soft in this area and the molars undergo a tremendous amount of pressure.

      Reply
      1. Zeny Terhune

        Thank you for your immediate reply. This was a duplicate question that I sent several days ago since I did not get or see your reply from the first one. Thanks again Dr. Amin.

        Zeny

        Reply
  7. jake

    I’ve had some bad experiences with some dentists….now I’m kind of afraid of them. My upper right side molers are gone, and now I have a receding gum near my tooth that is now a cavity, and am really living in pain everyday, and the 2 teeth below them are hurting as well and feel like they might have gum disease….I know implant cost a lot….but I don’t have money like that and this is clearly ruining my life….for a year I haven’t slept normal yet….Im always mad, in deep thought…..I can’t talk normally anymore without responding angry. I lost slot of weight over the course of a year. Im embarrassed to laugh. My breath is always bad…..and this has put a high burden on getting work…..I need help, I’m crying here…..I’ve been in and out of emergency rooms for over a year….I take Advil all day, I’ve been prescribed terrible pain medicine that irony work, as well s as seeping pills….I’ve been on antibiotics 5-6 Times in a year…..My mouth muscles are getting distorted, my mouth is either dry, or develops excessive saliva. Now im being told to see a psychologist, but I’m in pain and am in extremely discomforting circumstances. Im an artist and dance teacher for kids and can not continue if I can’t explain things verbally and properly. Please give me a remedy.

    Reply
    1. Ramsey Amin DDS

      Hi Jake,

      What a heart breaking story. There is hope. First off, consider having all of your dental work done under IV sedation anesthesia. This will make 2-3 hour dental appointments feel like 2-3 minutes. I do this 1-3 times a day for the last 15 years and it really helps patients your fearful of dentistry and who have had very negative experiences.

      You may want to consider extraction of all teeth and having traditional dentures made if finances are an issue. The other much better option would be fixed dental implant Bridges such as the Prettau implant bridge. It sounds like all of your teeth are in really bad shape and may not be able to be saved. The health of our mouth plays a big role on the health of our body and of course are emotions. I have seen many patients go through tremendous positive change in their life from just having their teeth restored to health, function and beauty.

      I hope you’re able to do something soon.

      Sedation
      Prettau Dental Implant Full Mouth Bridge

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  8. Philip

    Hello Dr. Amin,
    I tried to post before but it may have not been done correctly. I am trying to assess what is the next best route for me as my dentist just extracted my #2 upper molar. I was experiencing intense pain, what I later learned to be from an infection. The bone had deteriorated enough that there was no saving, along with the fact that the root was exposed. Almost 4 years ago I learned that I had severe gum recession which exposed the root of #2. I also tend to grind my teeth during my sleep.

    My dentist stated that I could go to an oral surgeon for a sinus lift, wait six months, get a bone graft and wait another six months for an implant. I think I got the order right, either way, it was going to be a year and a half. I have concerns from reading your articles of bone recession around the implant with patients with gum disease and grinding. I also have a concern about the socket now being empty and that I am further losing bone.

    My logic tells me to consult an oral surgeon and I assume it would be better to receive a sinus lift and bone graft now than later? Could you provide me any recommendations? Further, do you know of any dentists in the New York City area practicing the use of the patients own blood for recovery?

    Reply
    1. Ramsey Amin DDS

      Hi Phillip,

      The timeline of about 1 year sounds correct. You will likely need a lateral window sinus bone graft. This is different than the internal sinus lifts that you watched on this 3-D planning video.

      With only 3.5 mm of bone, the chance of doing a predictable, long-lasting internal sinus lift is not good especially in the position of tooth #2 rather than tooth #3. The anatomy is different.

      This is an area that I would suggest you treat very slowly. Because you grinds your teeth, the bone must be loaded carefully and you must have an implant of adequate size and length to support and upper second molar. I highly doubt you need a gum graft along with a bone graft in the area of tooth #2. This is more common in the upper front or lower front teeth. Your gumline can simply be repositioned to create more gum by how it is cut and sutured rather than having to add bone. This is called a split thickness flap dissection with apical repositioning. Sorry for all the technical terms.

      Then the York area you should not have a problem finding a Diplomate of the American Board of Oral Implantology that can handle a case as complex as yours.

      These web links may help:
      Dental Implants and SInus Lift – The Patient Perspective

      “Using Your Own Blood to Recover and Heal faster

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  9. Philip Wu

    Hello, I am a patient with gum disease that surrounded my #2 upper right molar. Had this diagnosed a few years ago. My gums receded enough at the time to expose the root some and I was told by the periodontist that it may last only a few years. Just over New Years I had serious pain there and learned from the dentist the following day that I had another infection and subsequently loss more bone requiring the tooth to be extracted. I was told I had about 3.56 mm of bone up until the sinus.

    The dentist advised that I could find an oral surgeon to perform a sinus lift, heal 6 months and then do a bone graft and wait another 6 months to heal before an implant. His estimate was that it could be up to a year and a half. I also suffer from grinding my teeth at night.

    Given what you have been told, do you have any recommendations on how to proceed? I read about your simultaneous sinus lift and bone graft wondered whether this is something suitable for me.
    I also now have any empty socket that I am worried will collapse on itself complicating my future efforts for a successful implant.

    My other concern was trying to increase the odds that if sinus lift and bone graft was successful along with implant to lessen the chance of losing any further bone. Also, would I need a gum graft to repair the wall that previously exposed the root.
    I am 36 years old from Queens New York, are there any doctors you would recommend here?

    Reply
    1. Ramsey Amin DDS

      Hi Phillip,

      The timeline of about 1 year sounds correct. You will likely need a lateral window sinus bone graft. This is different than the internal sinus lifts that you watched on this 3-D planning video.

      With only 3.5 mm of bone, the chance of doing a predictable, long-lasting internal sinus lift is not good especially in the position of tooth #2 rather than tooth #3. The anatomy is different.

      This is an area that I would suggest you treat very slowly. Because you grinds your teeth, the bone must be loaded carefully and you must have an implant of adequate size and length to support and upper second molar. I highly doubt you need a gum graft along with a bone graft in the area of tooth #2. This is more common in the upper front or lower front teeth. Your gumline can simply be repositioned to create more gum by how it is cut and sutured rather than having to add bone. This is called a split thickness flap dissection with apical repositioning. Sorry for all the technical terms.

      Then the York area you should not have a problem finding a Diplomate of the American Board of Oral Implantology that can handle a case as complex as yours.

      These web links may help:
      Dental Implants and SInus Lift – The Patient Perspective

      “Using Your Own Blood to Recover and Heal faster

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply