Implant Placement In 1 To 2 Mm Residual Alveolar Bone

An available residual bone height of approximately 1 to 2 mm was detected at the upper left first molar region with the width being 7 to 8 mm. we elevated the sinus membrane through the transcrestal route by using hydraulic pressure, mixed the deproteinized cancellous bovine bone (Bio-Oss; Geistlich Pharma, Wolhusen, Switzerland) with the Advanced Platelet-rich Fibrin (A-PRF), delivered the material into the maxillary sinus through the transcrestal window and then placed the implant simultaneously. Radiographic examination at 9 months after surgery showed ideal augmentation of the volume of the alveolar bone. No bone resorption was observed around the implant, and the final stability of the implant was sufficient enough to support the upper prosthesis. At the 3-year follow-up visit, the patient presented with good oral hygiene with no complain of discomfort. The success of implant placement in the resorbed posterior maxilla is typically dependent on the presented bone height and bone quality. In cases with severe bone height deficiency (the height from the ridge crest to the sinus floor is < 3 mm), a sinus elevation procedure by lateral window approach may be required to increase the bone height during initial-stage surgery, which is followed by implant placement in second-stage surgery. Featuring a special drilling system and the use of hydraulic pressure, maxillary sinus elevation through the transcrestal approach with simultaneous implant placement can be successfully applied in selected cases with 1- to 2-mm residual bone height.