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IM0410

tionthatisplaceduponthemembrane:sinceonlywa- tercreatesthepressure,theriskofaruptureisreduced considerably. At the same time, the amount of saline solution volume is monitored, thus ensuring a very precise knowledge of how much bone augmentation material should be applied (Fig. 2). In 2009 alone, 30 patientswithatotalof35sinusliftsweresuccessfully treated with the JEDER®-System. _Case report A 64-year-old edentulous patient who was wear- ing a full denture for almost two years wished a fixed prosthetic solution. The bone volume assessment showedaninner-antralboneheightof14–18mm.The bone height in the sinus area was between 3–5 mm. Preoperativeplanningisessentialforsuccess.Inorder to accommodate the high aesthetic demands of the patient a detailed surgical and prosthetic plan was prepared. It was determined that wax-up and navi- gated implantation were essential for a positive out- come of this case. The surgical procedure was divided into two parts: theimplantationandthesinusaugmentation.Inorder to assess the available bone volume a preoperative volume tomography was made (Planmeca; ProMax®, Helsinki; Fig. 7). Digital planning of the implant posi- tionswasmadepossiblewiththenavigatingsoftware Materialise®(DENTSPLYFriadent).Afurtherimportant toolinthissoftwareisthevirtualmeasurementofthe expectedvolumeofthesinuslift.Insodoing,avolume amount was calculated before the procedure itself, thus providing important knowledge of the saline so- lution volume and bone augmentation material re- quired and how much of both will be required during theoperationitself.Inthiscase0.88mlfortherightsi- nus, and 0.66 ml for the left sinus were calculated vir- tually (Fig. 8 and 9). For the minimal invasive sinus lift the described components P.B.D and S.V.P (Fig. 1A and B) were ap- plied.Becauseofthesmallcrestalopening(3.5mmdi- ameter x 5 mm in height) only a paste-like bone aug- mentationmaterialcouldbeused.Inourcasesweused Ostim® (Heraeus Kulzer). The intraoperative drill- splintfromMaterialise®madeanexactpositioningof the implants possible (Fig. 10 to 15). A postoperative I user report _ sinus lift Fig.11_Use of the A.T.P-Punch. Fig.12_All eight implant positions. Fig.13_Navigation splint in use. Fig.14_P.B.D in use. Fig.15_Placement of the implant after sinuslift. Fig.16_Postoperative volume tomography. Fig.17_Coronal view of the sinuslift. Fig.18_Emergence profiles. Fig.19_Individual zirkonia abutments. Fig. 20_Final restauration. 26 I implants4_2010 Fig. 15 Fig. 12 Fig. 13 Fig. 14 Fig. 11 Fig. 16 Fig. 17 Fig. 19Fig. 18 Fig. 20