Crestal Sinus Bump Utilizing A-PRF and I-PRF

A Patient came to me and I was able to help him start replacing missing teeth by being a patient in the M1 class. The patient had an implant placed in the #4 position but also needed an implant placed in the #3 position. The problem with #3 area is that crest to sinus is only 4.9mm. Dr. Engel has gone over sinus lifts in M1 but we stay within the realm of 7 mm of natural bone from crest to sinus when participants in the M1 class are placing their first implants and doing a sinus lift.

When you get experience with sinus lifts then you can do some more difficult cases involving crest to sinus that is less than 7 mm. The patient really wants to get an implant placed in the M1 class coming up in March 2019 in Concord so I got him in and I did a sinus lift for him. So I drew blood from the patient to for  I-PRF so I could make sticky bone.

While that was spinning in the centrifuge I made a garage door flap and started making my osteotomy to start elevating the sinus. I used my Versah burs to open up and osseodensify the area but after I opened up to the largest bur I perforated the membrane.

 

When I drawing his blood for the I-PRF I also drew a couple of vials for an A-PRF membrane.

Using the PRF kit from Salvin I made a plug and a membrane. I used the plug to close the membrane tear when I was using the Versah burs. I put the membrane in and proceeded to graft using Salvin’s Autotome.

Then I used the A-PRF membrane to cover up my graft and had primary closure.

2.0cc of 50:50 mix of Straumann allograft and Salvin-oss was used and mixed with I-PRF from the patient blood. I started off with 4.9 mm and I with the volume I increased to over 10 mm.

Remember to place your patient on sinus precautions and a precautionary dose of Antibiotics and Sudafed.

 

2 Comments
  1. matstewart1 3 months ago

    While completing a Crestal Sinus Lift did you compact the bone using the autotome or did you place the membrane then compact the bone manually and used the autotome to expand the cortical bone? Also, if you did not perforate would you have placed a membrane prior to the sinus lift?
    Beautiful work!

    • Author
      Darryl Burke 3 months ago

      I in this case actually used a combo of both. I had the autotome out but I did some manual tapping also.
      :).
      I would of tried a membrane but in my hands it hasnt worked to well. Now if i perforate I use BioXclude by snosasis medical.
      Cheers,

      DB

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