Short implant vs. Sinus Lift?

With all the new tools and materials , Sinus augmentation is now so easy and predictable as well as safer , simply why not

There are multiple techniques that allow up to 4 mm in height with a crestal approach. Less reliable techniques at times attain more. Why not place an 8 or 10 mm implant? If there is bone loss later in life a longer implant will last longer.

I agree with Peter! You can lift and place an 8 long or 11 long Bicon or a 6 or 9 long Quantum. Both will give the patient outstanding service.

Thank you for the advice. I do agree longer implant would be better, I was just hoping to avoid a sinus lift since I have not done one yet. I am comfortable with surgery, but for some reason the sinus makes me nervous. I guess I was the same way about implants before I got trained and finally started doing them. Any recommendations on techniques, instruments, kits?

This is a perfect indication for DIVA sinus lift and a 13mm long implant. And as Peter says, simply why not, a 13mm will last you a couple of lifetimes and it has 0 post op really.

"Easy" surgeries sound so nice....until a complication occurs. There is no such thing as easy anything. I still occasional struggle with fillings that I have done a million times. Training and experience gets you through. Moral of the story is to get yourself trained to do sinus lifts. Then it all becomes a piece of cake......sort of.

Some short implants can provide as much or more loading surface area as the longer counterparts. From the limited documents and history provided, this case looks like an ideal situation for a Bicon Short Implant. I’d usually place a 6x6 mm x 3mm post implant in this situation with the Internal sinus lift procedure. Check online (Bicon.com) for demos and training opportunities.

If the amount of bone available was in the mandible and very limited because of the inferior alveolar nerve , I would say you have no choice but to go with a very short implant, in bone that is much more dense....however, the density of the bone in the maxilla is less dense, and as stated above, a sinus lift these days is such an easy procedure, with very little effort....then for sure you must go longer...… consult with people in your area who are familiar with the techniques, your patient will thank you....

I have a good experience with short implant Bicon 5*5. In posterior maxilla in a case similar to that. Follow up more than 4 years. Good luck

I will place 8.5 or 8.0 mm long implant with sinus bump. no need for sinus graft.

Evidence for survival rates of short implants is good . This is an option should the patient want a less invasive procedure

The consensus of posts is that either option can be effective. I think it is important to offer BOTH options to the patient and not exclude one because you do not feel comfortable doing it...this is not fair to the patient

I’ve done a lot of crestal sinus lifts over the years with various techniques and found the Versah Burs to be by far the easiest and most predictable technique. I’d definitely do the sinus lift and place a longer implant.

I agree with Hal Wilson ,is an excellent technique

All great input, thanks. Both options will definitely be presented with full disclosure on my experience. I agree that longer implant in this situation would be preferable based on several of the comments. If I need to refer I will, but first I will research closed sinus augmentation and will look into the burs mentioned.

I've been using the Versah system successfully last 3 years. Dr Huwais offers a good training program. Osseodensification integrates well even in guided cases ( I use Cerec guide 2).

I have been placing BICON implants for years without a single implant loss. In this particular case I would feel comfortable placing an 8 mm implant and "bump" the sinus predictable and effective. If on the other hand I had less than the 6 mm and for whatever reason I did not want to invade the sinus a BICON implant is quite effective.

Every additional procedure comes with some additional risk factor. I’ve been using the EV short implants since they were brought out and find a similar success rate with the 6 mm long implant as I do with the 15 mm ones. I’ve been using short implants since 2002 with similar results. Just bury all threads, make sure there is adequate keratinized tissue on the buccal, and be sure there are no excessive occlusal forces on it. It will be fine.

I would do an 8mm long with a Versah drill lift. Very easy and you get better quality bone and cortical engagement at apex. I would have implant platform 1 to 1.5 mm subcrestal to give nice concave gingival abutment height 2 to 3 mm tall.

Nowadays Short dental implants are as predictable as regular implants and represent less morbidty, costs and treatment time. So, in my opinions short dental implant would be the treatment choice for this case. We recently published a paper showing 97% success rate of short (<8,5mm) implants in 48 months (mean) follow up (1 to 9-year).

Also consider what will be the final diameter of the implant platform and hence how closed the gingival embrasures will be. I like 6mm wide plateform implants for molars.

I will do sinus lift and put 11 mm length and 4'5 mm diameter implant .its more stable and will have more success than short implant.

good advice above , take away is to always advance your knowledge and clinical training, there are many intracrestal sinus lift kits/techniques for sale in the market place but just because we have a hammer not everything is a nail..... Clinical training reduces the practitioners ‘ stress and the patients infections ... .

Had a sinus lift in September 2010. Procedure planning after 4 months' healing . Continuing with 4 x implants with a a clip on denture protesis will finalise the process.

I dunno