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Atrophic ridge at 15–16: split crest, LMSF and Elevate in a single surgery

In one operation, Melillo addresses horizontal atrophy at site 15 and vertical atrophy at site 16. Melillo explains the anatomical assessment and the combination of split crest, LMSF, Elevate and grafting.

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Vertical ridge atrophy at site 16 and horizontal ridge atrophy at site 15, with an oblique sinus floor.

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Cresta atrofica verticalmente su 16 ed orizzontalmente su 15 con seno obbliquo.

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At site 16, the sinus CANNOT be assessed on a single cross-sectional view—my sincere advice to everyone. That is why I am including a 3D reconstruction.

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Zona 16 con un seno che NON può essere valutato in una semplice cross (consiglio spassionato per tutti). Ecco perché vi allego una 3d

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Site 15 requires horizontal augmentation and potentially vertical augmentation as well.

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Zona 15, che richiede di un aumento orizzonte ma volendo anche verticale

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Video showing the cross-sectional view.

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Visione cross in video

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The axial view shows how wide the sinus is and how it extends around site 17. According to the review we are conducting, this is an unfavourable sinus anatomy unless specific precautions are taken.

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Nella visione assiale si nota quanto il seno sia ampio e vada a girare attorno al 17. Questo è un seno sfavorevole secondo il lavoro di revisione che stiamo portando avanti. (Se non prendiamo qualche accorgimento).

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Postoperative intraoral radiograph: what did we do?

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Endorale post operatoria: Cosa abbiamo fatto?

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Using the Magnetic Mallet, we performed a split-crest procedure across the entire mesial segment with the Split and Cut tips. We expanded the residual bone with Black Ruby tips and displaced the sinus walls using Black Ruby according to the LMSF approach. We then completed the sinus-floor fracture at site 16 with Elevate. Tooth 18 was extracted and ground to produce dentine particulate. We detached and elevated the sinus membrane using hyaluronic acid, inserted the dentine particulate through the crestal access, and placed additional graft material within the split and on the buccal aspect.

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Usando il magnetic mallet abbiamo eseguito una split crest di tutto il segmento mediale Con le punte split e cut. Abbiamo espanso con black Ruby la quota di osso residuo Abbiamo dislocato il seno con i BR secondo l’approccio LMSF Abbiamo completato con elevate la frattura del seno su 16 Abbiamo estratto e tritato il 18 per generare particolato dentinale Abbiamo scollato ed allontanato la membrana con acido ialuronico Innestato particolato dentinale per via crestale Abbiamo innestato materiale nella split e additiva vestibolare.

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A few postoperative images. :) The entire procedure was performed through a small flap and in very little time.

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Un po di immagini post op :) Il tutto con una piccolo lembo. Ed in pochissimo tempo.

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A few photographs showing some additional “tricks”.

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Alcune foto con altri “trucchetti”

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Excellent! I would like to use these excellent images to let you know that two places have become available for the “Split-Crest and Crestal Sinus-Lift Masterclass” in Rimini on 17–18 April. If you are interested, please send Sara a WhatsApp message at 338 5913678.

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Figo! Sfrutto queste belle immagini per segnalare che si sono liberati un paio di posti alla _“Masterclass Split Creste e Rialzo di Seno Crestale”_ di Rimini del 17 e 18 aprile. Se interessati potete scrivere un messaggio whatsapp a Sara (338 5913678).

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Very nice—congratulations. Is there no video of the procedure? 🤷‍♂️

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Molto bello, complimenti, video dell' intervento no? 🤷‍♂️

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Unfortunately, I only have two photographs taken quickly on a colleague’s phone. They show that this was routine surgery performed during a day of consultancy.

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Due foto rubate col cell dal collega Purtroppo. È la prova che si tratta di chirurgia ordinaria in una giornata di consulenza.

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Osseotouch needs to invest in surgical lights with integrated cameras. 😂

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Bisogna che Osseotouch investa su lampade operatorie con telecamera 😂

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A G-COM in Manfredonia, please! 😂

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@⁨Kim⁩ Una Gcom a manfredonia pleaseeeeee 😂

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