Implants in maxilla: Depth and orientation?

I placed these 2 implants in the maxilla.  They extend into the maxillary sinus.  Do you think the depth and orientation is okay?  Are there any problems that I should anticipate?

12 thoughts on “Implants in maxilla: Depth and orientation?

  1. Craig Smith DDS says:

    My only other suggestion would be to do something about that mandibular bridge before restoring the maxillary implants. It looks like it was made to fit an extruded maxillary molar. I would cut the bridge, place an implant in the site of number 19, and restore them together for a more ideal occlusal plane. Love the root on number 29.

    • Jari Laitinen says:

      Highly recommended proposal to rehabilitate the occlusal plane! Afterwards it`s more expensive to restore the ideal occlusal plane, and it will be difficult to explain to patient why it would be beneficial make new crowns also to maxillary implants.

  2. Perioperry says:

    The sinus floor appears to be well above the apices of both implants. I agree with Craig Smith’s advice regarding the opposing occlusal plane.

  3. Feridoun Parnia says:

    The first one is good, I prefer the second one 2 or 3 mm distally, parallel to the last teeth to avoid cantilevere

  4. Maximiliano Hespanhol says:

    To answer your question, it would be necessary to have a CT scan.
    The panoramic X-Ray is very limited in precision and is quite impossible to comment on depth; too much anatomical overlay.

    All the best!

  5. matthew DMD says:

    Ditto to other comments. Don’t see that you are in sinus at all. Guess a CBCT would be a help and only way to judge. Good luck with case.

  6. Perioperry says:

    Can see clearly the maxillary sinus floor. The pano film here is sufficient confirmation that both implants are below the sinus.

  7. Dipika says:

    Great job. Agree with others. Little better spacing to allow better access for restoration, may be( difficult to say without seeing 3 D if possible or not)may be little longer for #15 to engage sinus floor for better retention and slightly better orientation to make them parallel to contact areas? Surgical guide -with 3 D dicomndata and impression or scanning with stml and merging those- I find it very helpful.

  8. OA says:

    Based on Panoramic no one can tell if orientation is good or bad. Orientation must be looked from four eagles B,L,M,D . Also B&L bone width must be taken into account. 2D image don’t give much info.
    I am sorry to say that and I know we all make mistakes, and nobody perfect, but do you know where the sinus is? You saying implants inside the sinus.
    If you not sure where the sinus is then I would recommend to take a course, this my professional advise. I am not trying criticize, just want to give you personal advise.

  9. Sean Rayment, DMD, DSc says:

    Hard to say based on the image but it looks like vertically they are well within bone. It would have been nice to push them more distal. I also would have considered removing the over-retained deciduous canine before restoring this area. Once that goes you will have a space issue that may not be fixed by rotating the adult canine (#11). Interesting case from a restorative perspective……

    • Tony says:

      Agree with all comments – two important points are as OA advises – you
      should try to look at more X-rays to familiarize yourself with anatomical structures if you are going to place implants – there are several no go areas in both jaws that you need to be aware of.
      Also google you tube presentations by Ziv Simon on the optimal angulations of implants on insertion. You will learn a lot .
      Implantology is great fun and gives a new dimension to your practice.
      Good luck


Comments are closed.

Posted in Clinical Cases, Surgical.
Bookmark Implants in maxilla: Depth and orientation?

Videos to Watch:

Single Tooth Replacement with Implants in the Esthetic Zone

Dr. Jack Hahn provides tips and reviews cases for implant placement in the esthetic zone.[...]

Watch Now!
Surgical Consideration for the Flapless Approach

In this video, Dr. Jack Hahn discusses and presents cases to review the surgical considerations[...]

Watch Now!
Bond Apatite: Socket Preservation Cases

These 2 videos show the use of Bond Apatite in socket preservation cases, one with[...]

Watch Now!
3D Guided Implant Placement

The placement of multiple implants in this case was helped thru the use of 3d[...]

Watch Now!
Ridge Splitting Cases in Narrow Alveolar ridge

This videos shows ridge splitting, which when combined with bone expansion, is an effective technique[...]

Watch Now!
Placement of 4 Implants and Cement-Retained Bridge

The treatment plan was to extract the lower incisors, canines, and lower premolar and place[...]

Watch Now!
Failing Bridge Replaced with Dental Implant Supported Bridge

Ahe patient presented with a failed dental bridge from the upper right canine to the[...]

Watch Now!
Lateral Sinus Augmentation with CGF

Following membrane elevation with the lateral approach, and confirmation of an intact sinus membrane, concentrated[...]

Watch Now!
Titanium Mesh for Ridge Augmentation

The use of titanium mesh is a reliable method for ridge augmentation to provide adequate[...]


Watch Now!
Implant Grafting Techniques: Demineralized Sponge Strip and Tunneling

This video reviews several unique grafting and surgical techniques, including the use of demineralized cancellous[...]

Watch Now!
Mandibular Fixed Screw Retained Restoration

This video shows the use of a surgical guide for a mandibular fixed screw retained[...]

1 Comment

Watch Now!
Clinical Tip for Fixation of a Collagen Membrane

This video provides a clinical tip with regards to the fixation of a collagen membrane.[...]

Watch Now!