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ePaper created 2018-02-16, 11:17:41 | version 1.38.0
| cone beam supplement dynamic navigation Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 11: A guide pin was placed in the upper right first molar site to check the depth and alignment. – Fig. 12: The NaviStent was removed and the site was prepared for the internal sinus lift. – Fig. 13: Sinus lift osteotome in place. – Fig. 14: The osteotome was tapped gently with a surgical mallet until the remaining thin layer of bone was infractured. – Fig. 15: A heterogeneous bovine bone graft material (Bio-Oss) was introduced into the implant site. – Fig. 16: Placement of 4.5 mm diameter and 6.6 mm length Ankylos C/X implant. – Fig. 17: Subcrestal implant placement. – Fig. 18: Ankylos Balance posterior sulcus formers were fitted, without the need for additional closure with sutures. planned prior to treatment and the consequent posi- tion of the implants determined, so that the optimum restoration could be achieved. Due to the limited bone depth in the first molar site, augmentation of the ridge was planned by utilising the internal sinus lift (or Summer’s) technique. The minimally invasive procedure allowed placement of dental implants in a site with reduced bone depth, without causing iatrogenic sequelae through dam- aging an intact Schneiderian membrane. Flapless procedure Treatment was carried out under local anaesthe- sia. The flapless procedure resulted in minimal trauma to the gingival tissue overlying the ridge. The previously constructed NaviStent, and the drill tag and jaw tag supplied by ClaroNav, were pre- pared immediately prior to surgery (Fig. 3). In ac- cordance with the Navident protocol, the axis of the drill and tip of the pilot drill were calibrated (Figs. 4 & 5) and verified before site preparation 44 CAD/CAM 4 2017