Abstract
Severe atrophic posterior maxillary ridge (residual bone height < 3 mm) could be a
challenging situation to place dental implants. Several treatment options have been
proposed, but some of them may require advanced surgical skills to achieve best results.
In this article, we present a novel and easier technique to allow implant placing
in localized areas of severe atrophy. In a first step, a 4.5-length extra-short (unloaded)
implant is placed after a transcrestal maxillary sinus floor augmentation (MSFA).
After the gained apical bone consolidation, this “temporary implant” is atraumatically
removed and a longer and wider definitive implant is placed to support the definitive
single restoration. The case of a 45-year-old female treated with this approach is
also presented. The patient suffered a severe resorption in the upper right molar
area after a tooth extraction. Four months after the “temporary implant” placement
and MSFA grafting with plasma rich in growth factors and autologous bone, 3 mm of
dense apical bone gain could be observed. In a second surgical time, the 4.5 mm-length
“temporary implant” was removed, and a 5.5 mm-length “definitive implant” was placed.
This second implant was placed in a denser type 1 (1,000 Hounsfield Unit) new formed
apical bone. Four months later, the implant was loaded with a screw-retained crown
over a transepithelial (intermediate abutment). After 1-year follow-up, the implant
was in health and no mechanical or biological complications were noticed. The satisfactory
results of this case encourage the realization of new studies to elucidate its reproducibility.
Keywords
sinus floor augmentation - short implants - bone atrophy
