Dental Implant (Possible Sinus Lift)

Mar 20, 2019
Would appreciate your advice on how I should proceed with a dental implant. So I had a failed root canal (infection and root fractures) and needed a tooth extraction and bone grafting on tooth 14. I went ahead with it late last June (2018) and ended up moving to another city for work so I couldn't complete the procedure with my original oral surgeon. I waited till January so that I could reload my FSA and immediately went to an oral surgeon in my new city who suggested I wait another 3 months (despite it already being 6 months since my extraction) since the bone hadn't ossified (according to the pano x-ray) and also gave me a treatment plan with a mandatory IV sedation (which would have been an additional 1600 out of pocket). I decided not to proceed since I didn't feel like I needed the IV sedation but did wait till early March for another consultation.

I then saw a periodontist recently who said that I only had 6mm of bone (when in actuality I had somewhere between 8-9mm) and gave me a treatment plan for a sinus lift/bone graft to go along with an implant. He said that for tooth 14, I should get a big sturdy implant and that he would use a 10x5mm implant and that he wouldn't go ahead with the procedure without a sinus lift. I sent my x-rays over to the oral surgeon who carried out my original extraction/bone graft and she said that she didn't think a sinus lift was necessary.

I then went to another oral surgeon for a second opinion and he told me that he would use a smaller implant (8mm) to avoid a sinus lift as best as he could, but that he may have to still carry out a sinus lift/bone graft on my plan in case it were necessary the day of surgery. (He won't know till he ends up taking a look.)

I know that it is hard to make any suggestions without an x-ray, but I'm getting mixed messages and I'm frankly confused and frustrated. I'm leaning towards the periodontist since he seems to have better reviews and would most likely not end up puncturing my sinus - although I may have to have a sinus lift unnecessarily. Having said that, I think the oral surgeon would most likely take a more conservative approach (even though he did say the sinus may be breached by 1-2mm) but at the same time, I may end up with a sinus lift if needed on the day of surgery - which would ned up costing the same.

Would appreciate your thoughts and input.

I have been advised from another dentist that I should opt for the oral surgeon (second opinion) since i have 8-9mm of bone height and since he would take a more conservative approach.


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