Dental Implant Placement at #25 with Crestal Approach Sinus Lift and Bone Augmentation Under Local Anesthesia
Surgical Procedure

Chief Complaint
Px presented for replacement of missing tooth at #25 site
Clinical Findings
Missing tooth at #25 site
Reduced vertical bone height requiring sinus augmentation prior to implant stabilization
CBCT reviewed for implant planning and sinus assessment
Treatment Plan
Implant placement at #25 site
Crestal approach sinus lift
Sinus augmentation with bone grafting material
Immediate temporisation with temporary crown
Risks, benefits, surgical procedures, and post-operative expectations explained to Px.
Pre-operative Assessment
CBCT reviewed prior to surgery.
Implant position, angulation, and sinus anatomy assessed and planned.
Risks including sinus perforation, infection, swelling, implant failure, graft loss, and post-operative discomfort discussed.
Px understood and agreed to proceed.
Informed consent obtained for implant placement with crestal sinus lift and augmentation.
Anesthesia
Local anesthesia administered to surgical site.
Surgical Procedure
Px cleaned and draped in sterile manner.
Incision made and buccal flap raised.
Implant osteotomy prepared using implant drills and osteotomes.
Crestal approach sinus lift performed.
Sinus augmentation completed using Osteon II collagen xenograft material.Implants prepped with Megagen Plasma treatment prior to placement.
3.5mm x 7.0mm Megagen Anyone Implant placed at #25 missing tooth site.
Temporary abutment (AO/ST) connected and torqued to 15Nm.
Immediate temporisation performed using composite resin.
Occlusion adjusted and finishing completed.
Temporary crown secured and torqued to 15Nm.Additional buccal bone grafting at #25 completed using Osteon II collagen xenograft material.
Flap released for tension-free closure.
BSS x4 placed for primary closure.
Haemostasis achieved.
POI given.

Post-operative Assessment
Post-operative CBCT taken.
Sinus augmentation successful with graft material well-contained.
Implant alignment and positioning satisfactory.
Bone graft adaptation dense and stable.
Px tolerated procedure well and left clinic in stable condition.
