The image above shows a missing upper left first molar with a very large maxillary sinus. The sinus is a hollow space which can extend into where the tooth roots used to be. The longer the tooth goes missing, the more likely the sinus pneumatizes, or expands. Because dental implants require bone for initial and long term stability, this can be a complicating factor during treatment.
Fortunately, with contemporary implants and meticulous surgery, a simple technique allows for implant placement without the need for sinus grafting and a long healing time. The "crestal" approach involves making a very small surgical access and preparing an implant bed through the bone while elevating a delicate membrane within the sinus. This technique is done under local anesthesia utilizing magnification and LED lighting. Patients can leave their appointment and return to normal activities right away and experience minimal post operative pain.
The above image shows the implant immediately after surgery is completed. Notice the implant extending into the dark area of the sinus.
The image above shows the same implant, well integrated, seven years after the original surgery. Notice how the bone has grown to near the bottom of the implant. This particular patient was referred back to have another implant placed. This surgical technique prevents the need for multiple surgeries while reducing healing time, treatment costs and risks for complications.