Here is a simple little Sommers lift case. #14 missing for a while. #18 and #19 perio involved and mobile.
Planned the implant about 1mm short of the sinus floor. We have about 7mm and I want 10mm. You can see that #18 is not doing so hot. Removed and grafted. Saw her during surgery and #18 and #19 are not healed enough so I will wait another month or two on those.
Started with a lance bur for two reasons. I want to see where I need to lay a flap (not a lot of attached tissue and if I get into the sinus I want primary closure). Also I want to get close to the cortical bone of the sinus floor so I needed something sharp.
Got the new Guided Crestal Lift Kit from Salvin. Although I have always been a fan of expanders I found they don’t work well in recently grafted sockets or areas where the sinus floor is slanted. Just set the stop and start banging!
My patient was not thrilled with the mallet, so after getting down to the floor we switched to the MIS Bone expanders. Look at the buccal as I am inserting the implant, we got a nice expansion of the buccal plate.
We got about 2-3mm of a bump. I traced out the former floor in purple. The I am palatal to the sinus. Primary closure. I am going to flap this at uncovery and lateralize the tissue and maybe also recontour the bone on the medial. I just want to see where things heal.