Extraction, Summers Lift, and Implant Placement: Can I Do This in One Visit?

Dr AP All of the things you mention are possible. You will need to decide based on the benefits versus the risks associated with these procedures. In immediate placement, often the angulation of the root is followed, even when one attepts to correct the angulation as one does the osteotomy. You have to underprepare the extraction socket. An osteotome elevation at the maxillary second molar site can be a little awkward, but I don't know if the width of the root would allow rotary bone expanders to be used for part of the procedure. In D-3 or D-4 bone, if you achieve the stability necessary, the implant may be successful. I personally prefer to extract and graft in that area, then come back and do the osteotome elevation and place the implant. In my hands, this is safer and more predictable. Good Luck.

Whatever your intentions are you can do it. Select the perfect size if implant & configuration. If it doesn't work you may wait for 7-9 months after the graft -before placing the implant. I have successfully done this in my dad. In fact I had only 4-5 mm of available bone I did one yesterday but a premolar. Doing implants since 25 yrs

In my hands the more predictable procedure is graft, then do the implant with sinus bump later. what's the rush for an upper second molar anyway? the osteotome in the upper second molar area is a bit awkward, now put it in an extraction socket and take away all remaining vision, essentially a blind procedure. yes you can do this, in my mouth i would rather have someone extract, graft, and then implant. i've done it both ways, and in your case i don't see any harm in doing the delayed procedure. i'm not a huge fan of the immediate molar implant. it can be done, but i like to make things easy for myself. with the immediate procedure, when would you load?? 4-6 months?? with the ext/graft, delayed implant technique i can have the case ready to load in 6-7 months with no sweat off my brow.

I see no reason to rush for a molar and I even prefer not to graft the socket in cases wher the roots are large. For me a staged proceedure is more predictable and I eliminate more variables. The more we do or put in at once the more can go wrong at once.

You can do something better regarding the situation. I sometimes do it and it works ok.It is a little difficult. I extract the tooth, use the Summers technique,I push the septum inside the sinus, graft and wait for 3-4 month and after that I have much more space for a longer implant. If needed i can do another sinus lift.

Personally I would not take this risk. Who knows but while extraction, u might rupture the thin Schnedrian membrane and Summers technique is a waste. Take a long cone parallel IOPA and confirm the distance between roots and the membrane lining. I would extract- wait for 6 weeks - then place an implant with summers technique. 7 mm Bone is never going to resorb so much that Summers technique is not possible. Gud Luck.

Perform a socket lift and graft, if this is a molar tooth. Revisit in 6 to 8 months and place an implant with no problems.

I wouldn't advise doing this treatment with molars. That's unless you still have 3 mm before you reach the sinus floor. But becareful with fused cases as there may be enough walls to engage for primary stability. Why add more risk with inadvertently tearing the membrane because lack of control of your osteotomes. Hitting centrally in the socket or/ septum can easily break the membrane. Another key problem comes later in trying to cover the over the graft...there's no tissue, leading to leakage and possible OAF complications. For single rooted premolars it's more predictable. The osteotomes guages well with the the root form and you can have a lot of control hitting with the hammer. You can release the buccal and palatal attached gingiva and should try to close over any part of the graft. I often place a tall healing cap on.