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.

 

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