Thursday, September 8, 2011

Hydraulic Sinus Lift/Extraction/Implant PLacement/Bone graft/Cytoplast

Molars are one of the most common teeth to receive fillings, crowns, rct , perio surgery etc etc. They are the teeth that we use most hence break down the fastest. When the molar is not able to be saved (rct failures, non restorable etc etc.) implant therapy shines.

Implants in molar sockets have historically been a long process. From extraction to bone grafting to sinus lift to implant placement the process can take over 1 year in time. With today's implant systems, bone graft materials and Piezo Surgery this process can be cut down to 3-4months. Here is a case I just did today.
#3 had failing endo that was unable to be retreated. Tooth had recurrent decay

a)#3 was atraumatically extracted by sectioning the roots and preserving the bone
b) Hydro-Dynamic Sinus Lift: Piezo surgery tip is used to lift the sinus with water pressure only, through the existing interseptal bone
c) no bone graft is placed in sinus cavity but rather a collatape to stabilize the clot and maintain the space
d) 5.8mmX12mm Biohorizon Implant is placed
e) socket is grafted with Dynablast
f) The biggest challenge with a molar is closure. So instead of raising a flap we guide the healing by gaining attached tissue. We place a cytoplast membrane that is removed at 4 weeks.

Also to consider is with molars no matter what you do you get lots of resorption after the extraction. So in immediate molars we like to place the head of the implant 2-3mm subcrestally. this allows for soft tissue development and  beautiful emergence profile.
Here is the case, any questions please place in comments box.

1 comment:

  1. Hi Jonathan, Great blog. I have added it to our education section at the dental lab industry blog it's a blog that Evident dental lab software has designed to help the dental lab industry for all aspects of the dental lab business.
    Thank you for your fantastic resource.
    Rayne Verity
    Marketing and Finance Manager
    Evident dental lab software