Loose teeth and tooth loss are concerns for many people, especially when the condition progresses severely, affecting chewing function and aesthetics. If you are seeking a solution for loose teeth, particularly cases requiring dental implants, understanding the procedure and choosing a reputable clinic is extremely important. This article shares a clinical case of molar restoration using the sinus lift and bone grafting technique, an optimal solution for cases with significant alveolar bone resorption, insufficient for conventional implant placement. Let's explore the procedure, results, and considerations for achieving a sustainable, healthy smile.

Patient's Oral Health Condition

At Herident, we frequently encounter cases of elderly patients experiencing severe periodontal problems. A typical case was a patient who presented with teeth #26 and #27 (two upper left molars) exhibiting Grade III mobility. This condition not only caused significant difficulty in daily chewing but also posed an imminent risk of early tooth loss due to alveolar bone resorption and periapical lesions. Therefore, the patient came to Herident seeking definitive treatment for the loose teeth condition and a stable restoration of their chewing function.

• Teeth #26 and #27 with Grade III mobility.
• Alveolar bone loss due to chronic periodontitis.
• The remaining bone was too thin and too close to the maxillary sinus, insufficient for placing a standard implant.

This is a rather common situation among elderly patients, where periodontitis progresses silently over a long period. By the time the teeth become noticeably loose and the patient recognizes the problem, the jawbone has already been severely destroyed.

Detail Diagnosis

After a thorough clinical examination and taking Conebeam CT (CBCT) scans (a 3D diagnostic imaging technique that allows doctors to clearly visualize the jawbone structure, teeth, and surrounding tissues), the doctors at Herident provided a detailed diagnosis of the patient's condition:

• Teeth #26 and #27 exhibited severe mobility (Grade III), indicating a serious weakening of the periodontal ligaments supporting the teeth.
• Significant alveolar bone loss was present around the roots of teeth #26 and #27, a direct consequence of prolonged periodontitis.
• The height and thickness of the jawbone at the location of teeth #26, #27 were insufficient to ensure stability for the implant post upon placement. Specifically, the jawbone was at risk of perforation into the maxillary sinus, a hollow structure within the facial bones, which would cause complications if implant placement were attempted without support.

Comprehensive Treatment Plan

Based on the diagnostic results, the team of experts at Herident developed a personalized treatment plan, combining multiple advanced dental techniques to comprehensively address the patient's condition and restore chewing function. Under the direction of PhD, MD Dang Trieu Hung, the treatment plan included the following steps:

• Extraction of teeth #26, #27: This is a necessary step to completely eliminate the source of infection, clean out the existing pathological tissues, and create favorable conditions for the subsequent treatment process.
• Open Sinus Lift: This is a complex surgical technique indicated when the jawbone height is insufficient. The surgeon will create a small "window" in the lateral wall of the maxillary sinus, gently lift the sinus membrane, and then place bone graft material into this created space. The purpose is to increase the bone height and volume, creating a stable foundation for future implant placement.
• Bone Grafting: Using artificial bone material or combining with growth factors from the patient's body (such as PRF membrane) to optimize the bone regeneration process.
• Implant Placement: After a period of healing and bone integration (typically 6-9 months after the sinus lift surgery), the implant posts will be placed at the location of teeth #26 and #27. Placing the implants at this time will ensure the posts have sufficient stability and optimal osseointegration.
• Fixed Porcelain Restoration: Finally, porcelain crowns will be fabricated and permanently fixed onto the implant posts, completely restoring the shape, chewing function, and aesthetics for the molar region.

The total estimated treatment time is expected to last about 6-9 months, depending on the patient's healing capacity and bone integration.

What is Open Sinus Lift?

Open sinus lift is a specialized dental surgical technique, applied in cases where patients have severe alveolar bone resorption in the upper molar region, resulting in insufficient bone height for implant placement.

• This technique involves the surgeon creating a small opening (window) on the lateral wall of the maxillary sinus.
• Afterward, the mucous membrane lining the sinus is gently lifted, creating a space.
• Artificial bone material, or sometimes combined with the patient's own bone, will be placed into this space to fill it and increase the height of the jawbone.
• The healing and bone integration process usually takes 6 to 9 months. After this time, the grafted bone will become solid, forming a stable foundation for placing the implant post.

Unlike the closed sinus lift technique (often used when the remaining bone height is about 4-5mm), the open sinus lift is indicated when the bone height is less than 3mm. This is a procedure that demands high technical skill, meticulousness, and extensive experience from the surgeon. However, it provides long-lasting effectiveness, definitively resolving the most complex clinical cases.

Procedure for Open Sinus Lift, Bone Grafting, and Implant Placement

Detail Procedure

The procedure for this clinical case at Herident adheres to standardized steps, ensuring safety and optimal results:

1. Examination and Diagnostic Imaging:

• The doctor conducts a clinical examination, checking the condition of the loose teeth, gums, and bone.
• Take Conebeam CT (CBCT) scans to accurately assess the jawbone structure, bone height and thickness, position of the maxillary sinus, and important anatomical structures.

2. Treatment Planning:

• Based on the diagnostic results, the doctor provides detailed consultation to the patient regarding their condition, feasible treatment options, pros and cons, and expected outcomes.
• Finalize the treatment plan, which includes tooth extraction, sinus lift with bone grafting, implant placement, and porcelain restoration.

3. Surgical Procedure:

• Local anesthesia: Ensures the patient is comfortable and feels no pain throughout the surgical procedure.
• Extraction of teeth #26, #27: Perform the extraction gently, preserving the surrounding bone tissue as much as possible.
• Open Sinus Lift Surgery: The doctor makes a small incision in the gum to access the lateral wall of the maxillary sinus. Create a bone window, lift the sinus membrane, and insert the artificial bone material. This process is performed under strict sterile conditions.
• Wound Closure: Suture the incision using absorbable stitches or stitches that require subsequent removal.

4. Healing and Bone Integration Phase:

• Patient follows the doctor's instructions for wound care, taking pain relievers and antibiotics (if needed).
• After about 6-9 months, the bone graft will integrate with the native jawbone, forming a solid mass. The doctor will re-evaluate with X-rays or Conebeam CT scans.

5. Implant Placement

Once the bone is sufficient, the doctor proceeds with the surgery to place the implant posts into the prepared site.

6. Porcelain Restoration

• After the implant has fully integrated with the bone (usually several weeks to several months after implant placement, depending on the implant type), the doctor will take dental impressions and fabricate the porcelain crowns.
• Finally, the porcelain crowns are permanently fixed onto the implant posts, completing the restoration process.

Achieved Results

After completing the entire treatment process, which lasted about 6-9 months, the patient regained two strong molars, ensuring effective chewing function. Comparison images before and after treatment show a clear change:

• The jawbone area at the location of teeth #26, #27 has been fully and solidly regenerated thanks to the sinus lift and bone grafting technique, completely eliminating the risk of sinus perforation.
• The implant posts were placed successfully and integrated well with the jawbone, creating a stable foundation just like real teeth.

The patient can chew comfortably, significantly improving their quality of life.

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Advice From the Expert

The patient's case above is a clear demonstration that, even with severe loose teeth, significant jawbone loss, or a lowered maxillary sinus, modern dental medicine still has effective solutions to restore lost teeth using advanced implant technology.

If you or your relatives are experiencing loose teeth or long-term tooth loss, do not hesitate to seek a dental examination soon. Timely diagnosis and consultation from a specialized doctor will help determine the most optimal treatment plan. The earlier the treatment, the higher the chance of saving the natural tooth (if possible) or achieving successful implant placement, while also saving costs and time.

At Herident, we are proud to be a leading reputable address in Hanoi, specializing in advanced implant techniques such as open sinus lifts, bone grafting, implant placement in the aesthetic zone, and implants for patients with complex systemic conditions. With our team of experienced doctors and modern equipment, we commit to delivering sustainable treatment results and maximum satisfaction for every client. If you are wondering "where to get good dental implants in Hanoi," the "cost of dental implants in Hanoi," or solutions for "implant placement after extraction," do not hesitate to contact Herident for a detailed consultation.