12:15 / 06:20Surgeon:
During the following operation Prof. Wachtel (Munich) inserts an implant to replace the missing upper right molar. Before, an orthograde sinus floor elevation with an osteotome is conducted as part of this surgery in order to extent the sinus floor.
To begin with, the prospective position of the implant is marked on the gingiva using a splint and a periodontal probe. Afterwards, a full thickness flap is prepared and the position of the implant marked again using the same splint mentioned above. The implant whole is drilled carefully according to the predetermined bone thickness available so far (7mm in this case).
After widening the implant cavity to three millimeters, a cylindrical osteotome is brought into the cavity to gently feel and tap the compact layer of the sinus floor. Once the osteotome has cautiously broken through the sinus floor the Schneider membrane is carefully pushed upwards. Bone substitute (Bio-Oss) is inserted as a cushion to help elevating the membrane slowly from the floor. In this case three Bio-Oss fillings are applied and coronally condensed with the osteotome. The implant cavity is finalized by gently pushing the ostotome into the sinus area beyond the 7mm mark. After testing the stability of the newly created sinus floor, the implant cavity is reshaped, and the implant with a length of 11,5mm is inserted in an epicrestal position. Finally, the two flaps are replaced and vertical mattress (double sling) sutures are applied to ensure a stable wound closure.