Trans-sinus implantation according to the “All-on-4” protocol

Prof. Aleksei Reshetnikov
Initial situation

A female patient (62 years old) reports discomfort when using a removable denture. 

Used biomaterials
  • Evolution
  • mp3®
Patient complaints: lack of teeth in the upper jaw, impaired diction and discomfort when using a removable denture

Patient complaints: lack of teeth in the upper jaw, impaired diction and discomfort when using a removable denture

Patient complaints: lack of teeth in the upper jaw, impaired diction and discomfort when using a removable denture

Patient complaints: lack of teeth in the upper jaw, impaired diction and discomfort when using a removable denture

Intraoral view. Severe destruction of the alveolar ridge of the upper jaw and soft tissue deficiency

Intraoral view. Severe destruction of the alveolar ridge of the upper jaw and soft tissue deficiency

Intraoral view. Severe destruction of the alveolar ridge of the upper jaw and soft tissue deficiency

Intraoral view. Severe destruction of the alveolar ridge of the upper jaw and soft tissue deficiency

Panoramic radiograph of the bone tissue. In red circle: the area with the most pronounced atrophy of the alveolar ridge of the upper jaw

Panoramic radiograph of the bone tissue. In red circle: the area with the most pronounced atrophy of the alveolar ridge of the upper jaw

After infiltration anesthesia, teeth #16, #17 and #27 removed, a vestibular incision was made and the mucoperiosteal flap was skeletonized. Formation of access to the anterior and lateral walls of both maxillary sinuses with mobilization of the Schneiderian membrane

After infiltration anesthesia, teeth #16, #17 and #27 removed, a vestibular incision was made and the mucoperiosteal flap was skeletonized. Formation of access to the anterior and lateral walls of both maxillary sinuses with mobilization of the Schneiderian membrane

Isolation of the oroantral anastomosis with collagen membrane Evolution. In positions #17, #12, #22, #25, #27, implants installed according to the V-II-V “All-on-4” protocol. Implant installed in position #15 using a delayed loading protocol

Isolation of the oroantral anastomosis with collagen membrane Evolution. In positions #17, #12, #22, #25, #27, implants installed according to the V-II-V “All-on-4” protocol. Implant installed in position #15 using a delayed loading protocol

Isolation of the oroantral anastomosis with collagen membrane Evolution. In positions #17, #12, #22, #25, #27, implants installed according to the V-II-V “All-on-4” protocol. Implant installed in position #15 using a delayed loading protocol

Isolation of the oroantral anastomosis with collagen membrane Evolution. In positions #17, #12, #22, #25, #27, implants installed according to the V-II-V “All-on-4” protocol. Implant installed in position #15 using a delayed loading protocol

Void between the anterior wall of maxillary sinus and the Schneiderian membrane filled with mp3®. Multi-unit abutments installed on the implants

Void between the anterior wall of maxillary sinus and the Schneiderian membrane filled with mp3®. Multi-unit abutments installed on the implants

Suturing around installed abutments

Suturing around installed abutments

Suturing around installed abutments

Suturing around installed abutments

Temporary prosthetics of the upper jaw supported by implants

Temporary prosthetics of the upper jaw supported by implants

Panoramic radiograph on the day of surgery. Temporary reinforced plastic prosthesis installed

Panoramic radiograph on the day of surgery. Temporary reinforced plastic prosthesis installed

Soft tissues 6 months post-op

Soft tissues 6 months post-op

Patient's smile after permanent prosthesis fixated

Patient's smile after permanent prosthesis fixated

Patient's smile after permanent prosthesis fixated

Patient's smile after permanent prosthesis fixated

Panoramic radiograph 6 months after implantation with a permanent prosthesis installed on the upper jaw. In oroantral anastomosis of the upper jaw there is a significant increase in bone tissue with the restoration of a new anterior maxillary wall on the right

Panoramic radiograph 6 months after implantation with a permanent prosthesis installed on the upper jaw. In oroantral anastomosis of the upper jaw there is a significant increase in bone tissue with the restoration of a new anterior maxillary wall on the right

Final result

Final result

Final smile

Final smile

Used biomaterials
mp3
mp3®
evolution
Evolution
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