Here is a case where I combined a lot of technology! I’m in my 40s and while guys my age are getting comb overs and corvettes, I’m out accumulating technological gadgets! I just got a new CO2 laser from DEKA and this thing rocks! It actually cuts like a scalpel! In this case we treatment planned for a Summers lift of the Sinus on #14. We had also planned for #29 and #30 implants, with #30 being an immediate but we had to punt and graft the socket as I had to remove too much bone. So I will post that case after she heals and we get back in there. Ordered two guides and two separate orders but one scan.
Although I am sure I have to practice more, the punch was really easy. and I was surprised at how quick the tissue came out. Again, one really cool benefit of this co2 laser is that it feels more “scalpel” like. When you move about the tissue you can see the cut. And of course you get that great heme control, because you all know how I hate the sight of blood!
Sinus expanders used after the 2.3. Start with the ones with a sharp apex then move to the dull ones. I use a ball ended probe to check in this case we are really in hard up-fractured bone so I did not feel the need to graft. I have bone surrounding my osteotomy.
Implant placed, tough to see but we have a “mound” of sinus membrane punched up past our implant. One thing that I don’t like about Sinus Expanders is that if you cant use them in the guide they walk. I could not really see the expander in my guide as I set the D2 high to get up to the sinus floor so I used them free hand. In my plan, the apex was where I wanted it to maximize bone, but my platform was closer to #13. In this case I am more upright, not tough to restore, but not perfect either.
Took off the standard cylindrical healing abutment and replaced with a contour healer. Due to the rotation of #12 I could not get it in the way I wanted it. In retrospect I should have just cut the healer on the meal as the end result was not as much tissue contouring as I would like.
I’m just not feeling the final crown ;{. Again, hindsight is 20/20 but you can see that #19 is buccal and supra erupted. I should have cut #19 down a bit to allow my crown to have better overlap and overjet. But I just love all sorry of custom abutments and this one was made by Implant Direct in their custom direct department, which will soon be offering Zirconia!