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?
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