This patient had two upper right molars removed due to advanced periodontal disease and bone loss. Following healing, the sites were noted with a bi-directional vertical bone deficiency. This means bone loss from the sinus side as well as the ridge side. While dental implants can be placed with a sinus lift only, the ridge deficiency would put the implants at a higher position than other teeth. This will create more challenge for hygiene access as well as will result in longer restorations which aesthetically and functionally are less ideal.
In order to optimize implants position and the restoration form and design, a bi-directional bone augmentation was recommended to develop the implant sites. Dental implants were then planned in 6 months.
During one surgery, a sinus lift bone grafting and a segmental technique with down repositioning of the ridge was accomplished. After a 6-month healing period, digital implant planning was completed for placement of 2 dental implants at ideal height. After 3 months of healing, the implants were restored.
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Keys to achieving this result:
- Proper site development by augmenting the bone in both directions
- Digital implant planning and guided implant placement
- Customized abutments and precision-fitting restorations