Implant in 13 Site: Opinions?

One of the important aspects of evaluating a patient for implants that require sinus lift is the feasibility of moving the membrane without perforating the membrane to the extent of making it beyond repair. One of the features would be smoking that can render the membrane thick and not pliable. In applying pressure to move the membrane one could perforate the bony crest as well that could be repaired in the hands of a knowledgeable and skillful practitioner. It that does not answer the question what would? The placement of an implant could potentially be accomplished after evaluating the potential risks and even then the patient must be willing to assume the risks and sign a well-prepared consent to treatment.

It’s a fine site as far as height goes. I’d use pilot drill to go just below floor and then widen with expanders either rotary or manual and then allow the implant to push up the floor/membrane, no graft needed it will fill in by itself. ( limited to 3 mm or so) If the width is too narrow then it’s a bit more complicated but doable.

X ray quality is not great. I would never plan a surgery with this level of info. Also what is you background in implants ? Thanks

I guess I would like to know what the prosthetic plan is. What good is a single implant at site #13 going to accomplish? Maybe a partial denture could serve adequately since there are missing teeth on both sides. I really cannot tell much about the sinus and tooth relationship on the radiograph even when I enlarge it. Maybe you could solicit a colleague to work with you on this - it is a complicated case. Thank you.