# 13 implant, Sinus lift?

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This topic contains 3 replies, has 2 voices, and was last updated by  Dr. Jay Reznick Mon Nov 13, 2017 09:30 am.

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  • #3058

    Lucas Eichmeyer
    Participant

    Hello, I am looking for some insight from some experienced surgeons so I thought that I would post this here 🙂
    This is a friend of mine, and really wants an implant placed in the #13 area, The sinus has pneumatized a bit and I am running into the sinus floor when I virtually place my implant. Is there a simple and predictable way to put the implant I virtually positioned (attached) with out doing a lateral sinus lift or an additional (expensive) procedure? I have heard people speak about a sinus ‘bump’. What is your protocol when there is ‘almost’ enough room? Thanks!
    Luke Eichmeyer DDS

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  • #3060

    Dr. Jay Reznick
    Keymaster

    Luke-
    There are a few options here. First, I like that you thought of using an EV Profile implant for this site due to the resorption pattern of the ridge. That is exactly what it is designed for. You have the apex of this implant placed just engaging the floor of the sinus, which is a reasonable thing to do. Remember, the EV drill will go 1mm beyond this point. A small violation of the sinus/membrane like this is rarely of any consequence, and should be successful. You could also opt for a shorter fixture. Studies are showing high success rates with 8mm and even 6 mm fixtures. The other option would be to do an indirect sinus lift (“bump”) to place bone around the apical portion of the fixture. This involves drilling short and then up-fracturing the sinus floor with specially-designed osteotomes, elevating the sinus membrane and pushing bone through the osteotomy in to the sinus floor. If you are unfamiliar with the technique, I would suggest taking our Essentials of Implantology, Level 2 course in 2018. Dates and location will be posted soon.
    Remember to add in the image of the guide sleeve in to your plan. You need to make sure that there is enough room for the sleeve, plus acrylic to hold it, interproximally. You may need to alter the implant position or angulation to accomplish this.
    Hope this helps.

    #3085

    Lucas Eichmeyer
    Participant

    Thanks for the reply Jay! I will absolutely look into those dates for level two when they are released. I really enjoyed level 1! I have not done a lot of training on the surgical side of dentistry yet. It would be nice to learn internal sinus lift. Thanks also for the videos on the site, they are really helpful, I really like the techniques you teach and the way you teach them, a very logical approach.
    Do you usually try to go longer in the maxilla versus the mandible? The implant I have is a 8mm profile conical. It is the shortest profile implant they have. Would you feel comfortable with an 8mm implant in the maxilla in a situation like this?
    Thanks again! Luke

    #3125

    Dr. Jay Reznick
    Keymaster

    The 8mm EV-C Profile should work well for this case. Shorter implants work just as well in the maxilla as in the mandible.
    We are scheduling a Level II course March 9-10 in Dallas. We should have the registration page active this week. Hope you can make it.

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