Female patient, 55 years old, with upper partial tooth loss class I of Kdy, who presented remnants of teeth 6 to 12 in the mouth, consulting for rehabilitation of the posterior sector.
According to the radiographic study, a large bilateral resorption due to pneumatization of the maxillary sinus was observed, so a reconstruction with implant bone graft was planned in a second stage. This treatment was rejected due to its high morbidity.
For this reason rehabilitation is planned based on dental implants to replace the first molar.
For this purpose, two tapered implants were installed on each side, three 45 mm and one 40 mm.
To rehabilitate based on fixed prosthesis was required the emergence of implants on the alveolar ridge, for which the original technique was modified.
Implants on the right side were installed at the level of teeth 3 and 4.
Posterior implant was placed outside the maxillary sinus and anterior implant was placed inside, but with a higher inclination than the occlusal plane.
On the left side, in the position of the dental pieces and 14, the anterior implant was positioned outside the maxillary sinus and the posterior implant was placed inside with the greatest challenge 13.
With this, it was achieved that the four implants emergated into the alveolar ridge with attachment within acceptable limits.
