PMC3819821_01
Baseline orthopantomogram showing that the subantral bone height was limited at the maxillary posterior left quadrant, with severely resorbed alveolar bone height at the site of the first maxillary molar.
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fig1
The initial orthopantomogram (Figure 1) revealed an alveolar bone height resorbed edentulous area in the upper-left posterior maxillary region with pneumatization of the maxillary sinus.
Radiograph taken after completion of the OSFE procedure without bone grafting with 8 mm lifting of the sinus membrane and a residual bone height of less than 3.0 mm and the amount of sinus floor elevation.
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fig2
The implant position, osteotomized portions of the sinus floor, and the amount of sinus floor elevation were visible on radiographs (Figure 2).
The CT and DentaScan reformatted flythrough image of the staged osteotome sinus floor elevation showing the intact Schneiderian membrane over the projection of the apical border of the first implant.
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fig3
Postoperative radiograph of the left maxillary quadrant four months after the placement of three implants with better initial stability medially and distally to the first implant showing the new sinus floor with all the implants appropriately positioned and inclined.
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fig4
Four months after inserting the implants, radiographs were taken and they showed the implant and surrounding bone under the tented sinus membrane in the upper-left first molar region (Figure 4).
Periapical radiograph after 12 months of prosthetic loading showing a stable clinical situation in the area around the apex of the implants.
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fig5
Radiographs taken at 12 and 24 months (Figures 5 and 6) showed a stable clinical situation in the area around the apex of the implants.
Periapical radiograph after two years of prosthetic loading showing a stable clinical situation in the area around the apex of the implants. A dome-shaped structure was apparent at the sites of the first and second molars.
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fig6
Radiographs taken at 12 and 24 months (Figures 5 and 6) showed a stable clinical situation in the area around the apex of the implants.
(a) CT scans showed the implant and surrounding bone and the new sinus floor using the staged osteotome sinus floor elevation technique on the left side 2 years after the operation. (b) Selected magnifying images for CT scans showed the implant, apical borders for these implants, surrounding bone, and the new sinus floor using the staged osteotome sinus floor elevation technique on the left side 2 years after the operation.
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fig7
Different CT scans, which were obtained after 24 months postoperatively, were used to show the implant, surrounding bone, and new sinus floor using the osteotome sinus floor elevation technique (Figures 7(a) and 7(b)).