Case description:
This clinical case illustrates the rehabilitation of a severely atrophied maxillary posterior sector (1 mm of subsinus bone). Thanks to a minimally invasive approach using successively Kits A and B for sinus elevation and bone grafting, the placement of two implants was successfully performed.
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- X-ray sector 15, 16.
- CBCT slices in position 16 showing a bone thickness of less than 4 mm, justifying the use of KIT A.
- Clinical view of sectors 15 and 16, clearly identifying the operative area.
- Creation of a full-thickness flap to visualize the external bone table.
- B.Y.1 at work
- B.Y.1 did not dive, let’s move on to B.Y.2.
- B.Y.2 at work.
- B.Y.2 dived successfully, revealing a bone disc surrounded by a bloody membrane.
- The osteotome pushes back the sinus membrane millimeter by millimeter, until it reaches 5mm.
- The bone-bearing syringe is filled with the filling material.
- The material is grafted into the opening, taking care to remove one millimeter with each osteotome pass.
- Careful closure of the opening after the graft.
- Performance of the sutures
- Postoperative X-ray showing the graft and the elevation of the sinus.
- 3-month check-up attesting to the stability of the graft.
- Operative preparation for the placement of the implants using KIT B.
- Insertion of two implants guided by KIT B.
- Final X-rays at 3 months postoperatively confirming the osseointegration of the implants.
Conclusion:
With the combined use of KIT A and KIT B, two implants (5/10 and 4.2/10) were placed in an area initially limited to a single millimeter of subsinus bone, demonstrating the effectiveness of the technique and the stability of the graft achieved.