Bone resorption after intralift sinus lift and immediate implant placement?
I have a healthy 56 year old male patient, non-smoker. I extracted #13 and placed an immediate implant, MIS 5×13. #14 was already missing a tooth. I did an intralift sinus lift using the MIS compression kit. I packed cortico-cancellous bone through the opening. I then placed an MIS 3.75×10 and achieved good primary stability and the radiograph looked good. I achieved good primary closure. The patient returned at one month to remove the PTFE suture and the radiograph showed significant bone resorption around the implant in #14 site. Any thoughts on this? Recommendations?
10 Comments on Bone resorption after intralift sinus lift and immediate implant placement?
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Lou
11/1/2016
Maybe you heated the bone up to much. Looks like the other implant may have problems also.
DrT
11/1/2016
Whatever caused it, it needs to be removed and the socket grafted ASAP
Mounir
11/1/2016
Thank you for your input, I already scheduled the patient to remove it but I can't think of a cause for that specially everything was fine day of surgery and achieved good stability and closure.
Dr.Al
11/1/2016
Either there was a lot of heat generated during osteotomy, or patient was not following instruction and chewing with that side. Sometimes severe diabetes can cause encapsulation issues. I would extract, debride and graft. Wait 4-6 months to place the implants. Good luck
Drg
11/1/2016
What was the ridge width like?
Mounir
11/1/2016
It was about 8-9 mm width.
Dr. Serge Goldmann
11/1/2016
I think simply it is too much compression on the bone with the MIS compression kit. It is a typical aseptic necrosis. Not related to the sinus lift you did well...
Khan
11/2/2016
Its very easy to think a cause. Its not always possible to find out he real etiology. think about the host. Despite best standards,techniques and protocols the host still plays a major role. Ask the medical doctor to carry out blood tests to find out any hormonal or haemantics deficiencies. Dont forget autoimmune conditions either.
Doctor X
11/2/2016
Perforation because you didn't place more mezial the implant. ...
Grade 4 bone osteoporosis? ?
When you do inter sinus lift and special after extraction need bone osteoexpander kit
Richard Hughes, DDS, FAAI
11/10/2016
You stated the patient was healthy! Did you perform blood studies. Ie.:, LDL cholesterol; Vit D level; HBA1C. These factors and certain medications are not good for bone. The other issues are possible over heating of the bone or too much pressure on the bone causing avascular necrosis.
There may be other systemic issues at hand. The prior doctors that posted made valid points to consider.
