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Technical Note:

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Newsletter Articles

Case Study 2 Socket Lift

The #1 obstacle to placing implants in the maxilla always seems to be the maxillary sinus, at least in my practice. To get around this, the sinus lift (developed by Tatum in the 1970’s) has been used. However, very few patients will submit to this procedure and the post-operative sequelae can be troublesome. More recently, the socket lift has been developed (popularized by R. Lazarra) in which an osteotome is used to elevate the sinus floor. This takes only 10-15 minutes extra and the implants can be placed during the same procedure. There are, however, limitations. You must have at least 7 mm of vertical bone height and it needs to be of good quality (type 2 or 3). The osteotomes, called Summer’s osteotomes, have a concave tip and come in 4 or 5 sizes, depending on what size implant you are placing. They are used incrementally from smallest to largest until the proper diameter is obtained. The only drilling that is done is the first twist drill, around 1.8 mm in diameter.

In this case, a bony septum was also present in the maxillary sinus. This actually helped because septae are cortical bone and can aid in the overall stability of the implant if they are adjacent to the implant fixture. This implant healed without any complications and was restored after 3 months of healing.

 

Pre-Op X-Ray Post-Op X-Ray     Osteotome Implant Placed
Abutment Placed	Crown Placed	4 Month X-Ray