To flap or not to flap, that is the question!

Categories ; Posterior, sinus lift, multiple implants, Nobel Biocare

Partially edentulous

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The fastest wax-up in the west

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BLP placed for screw retained restoration, prosthetically driven implant placement, necessitating shorter implant

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Bone driven implant placement, necessitating cement retained restoration

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Finished 3D Click Guide

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X-ray is diagnostic as buccal and lingual RIRâ&#x20AC;&#x2122;s overlap. No need for rotational adjustment, so use 0 degree green rotation blocks

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Site is flapped, drilled at 7 mm

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8.5 mm long implant OK as planned

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2.8 twist at 18-10 = 8 mm

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3.2 twist at 5 mm for stepped back preparation

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8.5 x 3.5 Nobel Active

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2 mm twist at 18-10-3 = 5 mm

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Correct length

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3.2 twist at 18-10-3 = 5 mm

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Sonic Kavo hand piece with insert indicated for lateral sinus lift, used for internal sinus lift. The bone will be abraded, while not affecting the soft tissue sinus membrane

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Opening into sinus, with intact sinus membrane

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Collatape first

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Unigraft, ceramic material

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Condensed with the MIS expansion instruments

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Nobel Active 8.5 x 4.3

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Implants placed as planned, sinus lifted. Submerged healing, while patients wears Removable partial denture.

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Flapped versus flapless

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