Maxillary Sinus Graft, 2 Implants, Crown Contouring > DENTAL FORUMS

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Implantology Dental Restoration Dental Labrotary
Maxillary Sinus Graft, 2 Implants, Crown Contouring

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Views : 1,370/ Jan, 20, 2023

  <GCaks> A 56-year-old male patient had pain-inducing caries, and perio-involved tooth mobility resulted in a tooth fracture at 1st molar. And it was removed months ago. He was a heavy smoker and showed poor oral hygiene.

Pre-op panoramic radiograph.▲Pre-op panoramic radiograph.Intraoral view before the maxillary sinus graft▲Intraoral view before the maxillary sinus graftLateral window using reamer▲Lateral window using reamerSinus membrane elevation procedure with all-in-one sinus curette.▲Sinus membrane elevation procedure with all-in-one sinus curette.Bone material(Xenograft) was applied into the prepared sinus cavity.▲Bone material(Xenograft) was applied into the prepared sinus cavity.Absorbable collagen membrane was placed on the grafted site. (Lyoplant®)▲Absorbable collagen membrane was placed on the grafted site. (Lyoplant®)Suture was done (Nylon 4-0)▲Suture was done (Nylon 4-0)Radiograph was taken right after maxillary sinus graft▲Radiograph was taken right after maxillary sinus graftCBCT after 1month of maxillary sinus graft▲CBCT after 1month of maxillary sinus graft4 months after sinus graft. Intra-oral view on the day of implant surgery. It was scheduled that the 2nd molar extraction and 2 implants would be placed in the 1st and 2nd molar zone.▲4 months after sinus graft. Intra-oral view on the day of implant surgery. It was scheduled that the 2nd molar extraction and 2 implants would be placed in the 1st and 2nd molar zone.The 2nd molar extraction ▲The 2nd molar extraction Insertion torque was 35Ncm at the 1st molar zone. Arum NB1, 5*10▲Insertion torque was 35Ncm at the 1st molar zone. Arum NB1, 5*10Lateral view. Check the 3-dimensional position and occlusal relationship with the Arum direction pin.▲Lateral view. Check the 3-dimensional position and occlusal relationship with the Arum direction pin.Occlusal view. Check the 3-dimensional position and occlusal relationship with the Arum direction pin.▲Occlusal view. Check the 3-dimensional position and occlusal relationship with the Arum direction pin.Insertion torque at the 2nd molar zone was 20Ncm. Arum NB1, 5*10▲Insertion torque at the 2nd molar zone was 20Ncm. Arum NB1, 5*10A healing abutment was connected to the immediately placed implant▲A healing abutment was connected to the immediately placed implantGBR was performed at the immediately placed area. Xenogrtaft+CGF▲GBR was performed at the immediately placed area. Xenogrtaft+CGFCGF was placed on the grafted area▲CGF was placed on the grafted areaA membrane-engaged healing abutment was re-screwed into the fixture after unscrewing it.▲A membrane-engaged healing abutment was re-screwed into the fixture after unscrewing it.The flap was closed.▲The flap was closed. A panoramic radiograph after 2 implants were placed in the right maxilla.▲ A panoramic radiograph after 2 implants were placed in the right maxilla.CBCT scan image focused on the 2nd molar zone.▲CBCT scan image focused on the 2nd molar zone.CBCT scan image focused on the 1st molar zone.▲CBCT scan image focused on the 1st molar zone.4 months after implant placement. Intraoral view on the day of implant uncovery(2nd surgery).▲4 months after implant placement. Intraoral view on the day of implant uncovery(2nd surgery).4 months after implant placement. Implant uncovery and ISQ reading was performed. ISQ values at the 1st molar area.▲4 months after implant placement. Implant uncovery and ISQ reading was performed. ISQ values at the 1st molar area.ISQ values at the 2nd molar area.▲ISQ values at the 2nd molar area.After the ISQ reading, the healing abutment was engaged to the fixture.▲After the ISQ reading, the healing abutment was engaged to the fixture.When viewed from the side, the embrasure area was not opened enough. That should be re-contoured.▲When viewed from the side, the embrasure area was not opened enough. That should be re-contoured.The embrasure area was re-contoured.▲The embrasure area was re-contoured.Abutments were connected to fixtures▲Abutments were connected to fixturesSeating trial ▲Seating trial Intra-oral view after delivery (permanent cementation and access hole filling with composite resin).▲ Intra-oral view after delivery (permanent cementation and access hole filling with composite resin).CBCT scan focused on 1st molar area after crown cementation▲CBCT scan focused on 1st molar area after crown cementationCBCT scan focused on 2nd molar area after crown cementation.▲CBCT scan focused on 2nd molar area after crown cementation.
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