Skip to main content
Dr. Bahat, Dr. Zabalegui, Dr. Berroeta, Mr. Pérez

Nobel Biocare N1™ concept in the posterior maxilla with sinus floor elevation

Dr. Oded BahatDr. Ion Zabalegui, Dr. Eva Berroeta, Mr. Javier Pérez

Spain

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Implant placement associated with immediate sinus floor elevation at sites with inadequate vertical bone height.

Patient: female, 47 years

Clinical situation: healed site at tooth position 15, 16 (FDI) with bone resorption

Surgical solution: placement of two implants with simultaneous sinus floor elevation

Restorative solution: 2 single crowns

Surgery date: Bilbao, April 25, 2019

Total treatment time: 12 months

Tooth position: 15, 16 (FDI) 3,4 USA    

 

 

 

Patient treatment courtesy of Dr. Oded Bahat, Dr. Ion Zabalegui, Dr. Eva Berroeta, Mr. Javier Pérez.

Some products may not be regulatory cleared/released for sale in all markets.

Please use landscape mode when viewing this page on mobile.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Initial clinical situation

Partial edentulism right side maxilla with vertical ridge deficiency.

Healed site before surgery. Lateral view (left).

Healed site before surgery. Occlusal view (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Treatment planning

CBCT Pre-op. CBCT illustrating inadequate vertical bone height, right side and healthy sinus. Mucosal thickening left sinus.   

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Flap delineation and full thickness elevation.

Marking of flap (left).

Buccal view of ridge (right).     

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

OsseoDirector™ instruments (2000 rpm with irrigation). Initial osteotomy with the OsseoDirector instrument. The final length and implant position established (left).

Osseoshaper™ instrument* preparation of the site at 50rpm without irrigation (left).                                                                                   

* In this clinical case the pre-launch version of the OsseoShaper™ instrument has been used: the “CS Soft Bone Gizmo”. Black markings on the shaft and a 0.5 mm longer tip on the instrument are introduced on the final design of the OsseoShaper™ instrument.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Implant followed the direction created by the OsseoDirector™ and OsseoShaper™ instruments* (left).

Flat side of the trioval implant facing buccal (right).

* In this clinical case the pre-launch version of the OsseoShaper™ instrument has been used: the “CS Soft Bone Gizmo”. Black markings on the shaft and a 0.5 mm longer tip on the instrument are introduced on the final design of the OsseoShaper™ instrument.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

OsseoShaper™ instrument* at full depth. The end of the threads indicates the position of the implant shoulder relative to the bone crest (left).

Reversing to remove the instrument (right).

* In this clinical case the pre-launch version of the OsseoShaper™ instrument has been used: the “CS Soft Bone Gizmo”. Black markings on the shaft and a 0.5 mm longer tip on the instrument are introduced on the final design of the OsseoShaper™ instrument.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Autogenous bone is maintained within the osteotomy and within the threads of the instrument (left)

Sinus lift with osteotomes after site preparation (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Implant insertion 70 Ncm. Final placement of the implants. Flat part on the implant driver and vertical corresponding groove within the mount corresponds to the trioval flat aspect facing the facial aspect 

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Transmucosal base placed at time of surgery (left).

Healing caps and the base function as healing abutments (right).      

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Flap closure. Healing caps and the base jointly shape mucosa (left).

Radiographs immediately post-op (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

CBCT immediately post op illustrating the implants position and sinus floor.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

CBCT Pre-op (position 16) illustrating inadequate vertical bone height.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

CBCT Post-op (position 16) illustrating implant placement and sinus elevation.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr. Berroeta and Mr. Pérez

Outcome

12 month post-op final restoration.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr. Berroeta and Mr. Pérez

Outcome

35 months post-op. Follow up (left).

CBCT 35 months post-op (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr. Berroeta and Mr. Pérez

Outcome

35 months post-op facial view.

Related products

Sign up for our blog update

Get the latest clinical cases, industry news, product information and more.

© Nobel Biocare Services AG, 2019. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. For prescription use only. Caution: Federal (United States) law restricts this device to sale by or on the order of a licensed clinician, medical professional or physician. See Instructions For Use for full prescribing information, including indications, contraindications, warnings and precautions. Nobel Biocare does not take any liability for any injury or damage to any person or property arising from the use of this clinical case. This clinical case is not intended to recommend any measures, techniques, procedures or products, or give advice, and is not a substitute for medical training or your own clinical judgement as a healthcare professional. Viewers should never disregard professional medical advice or delay seeking medical treatment because of something they have seen in this clinical case. Full procedure is not shown. Certain sequences have been cut.