Block Regeneration and Sinus Lift Combined in One Case
This case highlights a complex rehabilitation using block regeneration and sinus lift techniques in a 55-year-old patient. He presented with a failed removable upper prosthesis and requested a fixed solution.
Initial Assessment and Surgical Plan
The patient had no significant medical history. A CT scan revealed the need for implants in positions 23, 25, and 26. However, we identified a horizontal defect at the canine (23) and a highly pneumatised sinus posteriorly.
We decided on a three-part surgical approach:
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Block grafting at position 23
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Regeneration after extraction at 24
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Sinus lift for site 26
Technique 1: Block Graft in the Canine Region
We placed the implant in 23, oriented through the cingulum. Since it lacked buccal bone support, we harvested a block graft from the ramus. One half was particulated to pack around the implant; the other was fixed with screws to reconstruct the defect.
Technique 2: Regeneration with Titanium Mesh
During the extraction of tooth 24, the buccal bone fractured. We placed the implant engaging the distal alveolar wall and used autologous bone plus titanium mesh to support the graft.
Technique 3: Sinus Lift with Cadwell-Luc Access
We lifted the Schneiderian membrane and grafted with a mix of ramus and tuberosity bone. The same mesh used in site 25 closed the sinus window. After four months, we’ll re-enter without periosteal detachment, transposing 3–4 mm of keratinised gum.
🔗 See more clinical cases of bone regeneration
📎 Sinus lift procedures – PubMed
