Osseo News Logo

The Original Dental Implant Community

Sign In

Deficient palatal bone wall: best approach?

Last Updated: Jun 20, 2017

I have a female patient in her mid-forties who is a non-smoker, stable periodontal status, and non-contributory medical history. She presents with missing 12-18 on her maxillary right quadrant. Her chief complaint is that she wants teeth on her maxillary right quadrant replaced.

I have treatment planned her for implants in 16, 14, 13, 12 sites. In 14, 13, 12 sites I have planned closed crestal sinus lifts with GBR. I will allow the graft to heal for 6 months then place the implants. I will use regular platform implants for 14, 13, 12.

After CBCT analysis, I noticed the deficient palatal bone wall on slices 48 and 50. I am not sure what this is. What could it be? Has that wall been lost due to trauma or draining sinus, or is it actually an anatomical structure? What will be the best approach in this case? Should I open the flap and graft and re-enter again at 3 months? Should I leave this implant out from my treatment planning?



9 Comments on Deficient palatal bone wall: best approach?

Dennis Flanagan DDS MSc

06/20/2017

I'm a lover of flapless split and expand ridge augmentation. Which may work nicely here. However, this cannot be your first ridge split case.

Raul R Mena

06/20/2017

Please enlighten me as to were there is a need for sinus lift of for bone expansion in this case. By the way also explain as where is the need for GBR or what do you mean by GBR in this case?

Merlin Ohmer

06/20/2017

No need for a lift. Expand the ridge. You have lots of length. Measure further down and see if you can get width if you flatten the ridge some.

Cesar Gutierrez

06/20/2017

First I do not recommend you place the implant in the 16 site. You ll have a higher implant failure rate in this region. It's also a uncomfortable place to do the surgery. For what i see Why not a ALL on 4 or ALL on 6 upper jaw. I can not tell you anything because 48- 50 Slide not found.

Carlo

06/21/2017

Where are slices 48-50 in the cross sections? Are you referring to the markings in the panoramic view?

mehrangaroosy

06/21/2017

This image is from slices mentioned above.

Carlo

06/22/2017

Most likely, the result of some pathology. Why were theeth lost /extracted? How about placing implants in 1.2, 1.4 and 1.6 only thus avoiding the area and maintaining some distance between implants?

mehrangaroosy

06/26/2017

I am not sure carlo,even I place one fixture in slice 52,distal wall still will be in the lesion.

Carlo

06/26/2017

Even so, the defect can be grafted at time of surgery after removing/perforating the cortical lining

Featured Products

DALI Bone Mix

DALI Bone Mix

The highest quality tissue!

Classic

Classic 50/50 Mix

Promotes osteoconduction

Provides structural integrity

DALI Bone Syringe

DALI Bone Syringe

Prefilled Mineralized Cortico-Cancellous Bone in Syringe

New

Convenient Syringe!

50/50 Cortical/Cancellous

Available in 3 sizes.

Osteogen Plug

Osteogen Plug

Combines bone graft with a collagen plug.

Classic

Eliminate hassle of mixing particulate grafts

Sold in packs of 5 or packs of 10.

Proven safe, and clinically effective

OsseoSeal Flexible Membrane

OsseoSeal Flexible Membrane

Resorbable collagen membrane derived from purified porcine pericardium

Popular

Fast hydration and excellent tensile strength

Good adaptation to various defects

Excellent tear function and duration

DALI One Graft

DALI One Graft

One-Step grafting solution!

New

100% allograft

Eliminates mixing hassle

Moldable after hydration