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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.

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