Two-Step Progressive Transcrestal Sinus Augmentation Using a 4.5 mm Unloaded Implant as a “Temporary Implant” in Highly Atrophic Ridge: Case Report

Abstract

Severe atrophic posterior maxillary ridge (residual bone height < 3 mm) could be a challenging situation to place dental implants. Several treatment options have been proposed, but some of them may require advanced surgical skills to achieve best results. In this article, we present a novel and easier technique to allow implant placing in localized areas of severe atrophy. In a first step, a 4.5-length extra-short (unloaded) implant is placed after a transcrestal maxillary sinus floor augmentation (MSFA). After the gained apical bone consolidation, this “temporary implant” is atraumatically removed and a longer and wider definitive implant is placed to support the definitive single restoration. The case of a 45-year-old female treated with this approach is also presented. The patient suffered a severe resorption in the upper right molar area after a tooth extraction. Four months after the “temporary implant” placement and MSFA grafting with plasma rich in growth factors and autologous bone, 3 mm of dense apical bone gain could be observed. In a second surgical time, the 4.5 mm-length “temporary implant” was removed, and a 5.5 mm-length “definitive implant” was placed. This second implant was placed in a denser type 1 (1,000 Hounsfield Unit) new formed apical bone. Four months later, the implant was loaded with a screw-retained crown over a transepithelial (intermediate abutment). After 1-year follow-up, the implant was in health and no mechanical or biological complications were noticed. The satisfactory results of this case encourage the realization of new studies to elucidate its reproducibility.

The Effect of Denatured Albumin with Concentrated Growth Factors in Minimally Invasive Sinus Piezosurgery: Preliminary Pilot Study Results

“…5), and (e) its viscosity and therefore of its excellent bone-to-graft contact, and graft-to-implant contact (►Figs. [3][4][5].…”

“…In transcrestal closed-type cases with indirect compression osteotomy (Summers, 1994-indirect SAT), the method is considered not invasive and relatively safe. 3 Many protocols and techniques have been introduced in dental practice based on the same biological principles 4 5 and, among others, the Intralift technique with Piezotome and hydrostatic lifting of the membrane. 6 Bioengineering and regenerative medicine collaborations have provided new blood-derived autologous grafts, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factors (CGF).…”