[Surgery]  SA4 Sinus augmentation #26

Good morning everyone,

I have done a few of these cases but not many.

Any advice on how to get the best out come?  There is about 2mm of bone and I am thinking augmentation first, allow to heal and then implant 6 month later.  Would be nice to engage an implant and use CASK but I don't think 2mm of bone is enough.


Sticky bone or particulate?

Appreciate any input you may have for me



p.s. #36 was extracted by a specialist, no grafting was done. 

by Anand Choubal at Wed, Jan 24, 2018 7:16 AM

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Mark Kwon Replied at Fri, Feb 2, 2018 9:08 PM

Definitely a lateral because if the membrane tears you will need to fix it!

These are actually quite tricky. 

These often results in tear due to limited space to enter. Hard to make large enough windows. 

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Ho-Young Chung Replied at Wed, Jan 24, 2018 11:16 AM

Hi Anand,

This is definitely an open lateral window case (not crestal).  You are better off doing the augmentation first then placing implant 6 months later. 

I'm not a fan of LASK Kit.  I prefer using round diamond and round carbide especially in tighter space like this.  My favourite sinus instrument kit is from Surgical Smart.  Their gold tipped instruments are sharper than any that I have used.  

Making the window will be your most difficult part here.  I would rate this lift as more advanced and if you are unsure, having a mentor over the shoulder would be a better learning experience for you.  Having adjacent teeth on either side makes this case more challenging.

Also, please do vitality testing on adjacent teeth and make sure CBCT confirms that there is no radiolucency at the apex of 25 or 27.  

Ho-Young Chung