Explantation and Implantation with Sinus Lift: Rehabilitating the Posterior Maxilla

This case demonstrates the management of complex implant failure and reimplantation in the posterior maxilla through explantation and implantation with sinus lift. The patient, a healthy 37-year-old, had two implants placed in positions 14 and 16 two years earlier.

Implant Failure and Surgical Reassessment

Over time, the implant in position 16 failed due to insufficient bone support. Only minimal residual bone remained. Meanwhile, the implant in position 14 remained in place but presented poor prognosis.

It was significantly angled, separated from tooth 13, and showed visible thread exposure due to 6–7 coil bone loss. We determined both implants required removal and the site needed vertical and posterior reconstruction.

Combined Surgical Approach: Sinus Lift and Grafting

We began by removing the implant in position 14, which detached easily due to limited osseointegration. Next, we accessed the sinus using the Cadwell-Luc technique and performed a lateral window sinus lift.

To ensure proper prosthetic emergence, we placed new implants in positions 14 and 16. For bone grafting, we harvested a block from the mandibular ramus, particulated it, and packed it inside the sinus cavity.

Closure and Graft Protection

We finalized the procedure by closing the lateral window using titanium mesh secured with osteosynthesis screws. This step protected the graft during healing and supported long-term volume maintenance.

📎 Sinus grafting and reimplantation strategies – PubMed
🔗 See similar clinical cases