Abstract

This paper presents a combination of techniques to replace a missing first premolar in an atrophic posterior maxillary ridge with less than 4 mm of residual bone. Simultaneous sinus lift and implant placement were carried out as a delayed-immediate procedure 6 weeks following the extraction of the premolar. The osteotome technique was used to gain primary stability. Demineralized freeze-dried bone and deproteinized cancellous bovine bone (Bio-Oss) were used to create the bone volume. Autologous fibrin adhesive was subsequently used to stabilize the bone grafting materials both in the sinus and on the coronal part of the implant. This combined technique preserves the alveolar bone after extraction; simplifies the primary closure; avoids a second surgical site; and reduces the total operation time, cost, and inconvenience to the patient.