One Step or Two Step Process for Implants?

Greg asks:

A surgeon has recommended a one-step sinus lift and placement of implants procedure for teeth # 2 and 3. I am in my sixties. He has taken a panorex. Is a cat scan also necessary? I do not want to cut corners here. Also, is the one step process instead of the two step process a better choice? Do the lift, then wait to put in the implants months later, is this riskier?

Answered by: Dr. Carlos Boudet

West Palm Beach, FL

Dear Greg,

If you need a sinus lift, it is because there is not enough height of bone in the area to place implants of adequate length. The implants can be placed at the same time as the sinus elevation, or several months after to allow the grafted area to become usable bone before the implants are placed.

Also, the cat scan is necessary when doing a sinus augmentation procedure.

Whether you can have the one-step procedure, depends on two very important factors:

1. There should be enough existing bone to stabilize the implants (the consensus is 4-5 millimeters of bone height,)and

2. The surgeon must obtain adequate stabilization of the implants. In other words, the implants need to be tight, not loose. This second condition is harder to achieve since that area of the mouth is characterized by very soft bone that can make implant stabilization difficult to achieve with only 4 or 5 millimeters of bone unless the surgeon is familiar with the available modifications of the surgical technique needed such as bone compaction, etc...

The two step dental implants procedure is safest in most hands, but the one step procedure in the hands of an experienced surgeon is just as predictable and it saves you a second surgery.

Timewise, the difference may be six months or a year.

Good luck!