Prosthetic completion of a case with a pterygoid implant
Good evening to all, following the finalization of a case of sectorial pterigoid implant Rx preoperative in which there is evidence lesion in the…
Shared clinical experience
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Real cases, images and clinical decisions: explore the experiences shared by colleagues.
84 clinical cases
Site 15: sinus wall displacement with Black Ruby and a shorter implant
Zone 15 , intervention in consulting therefore with few means, what I like is the distal shift of the breast wall , with BLK R1 and 2 . Since the…
Sinus elevation with Elevate in a ridge with about 3 mm of residual bone
Extreme case. 3 mm average of height. Here only elevate 5 Stop 2/3/4 Ialuronico Acid and biomaterial Implant 4.5 h8.5 Post op (horrible section 😅)
Ridge split and implant placement in the mandibular molar region
Ridge split and 4.5 mm fixture placement in ridge width of 4 mm with magentic mallet in lower first molar region
Modified sausage bone regeneration with dentin and PRF
I suggest the use of erbium yag laser, diode laser, magnetic Mallet (with first), and dentine (with Tooth Transformer) with PRF for the “Modified…
Crestal sinus elevation with Elevate and grafting in very soft bone
Indirect / internal sinus lift with Elevate kit and bone graft Extremely soft bone Remaining bone height was 3 mm and 5 mm
Two immediate implants with sinus elevation and a provisional bridge
Case of the day. Tooth 1.5 was lost And in the zone 1.6 we had a huge defect affecting also the tooth 1.7 So I did 2 imediate implants to reduduce…
Crestal sinus lift with Elevate, collagen and Biosorb
Fabio Caliendo describes a crestal sinus lift with a 2 mm drill, Elevate tips with stops at 6 mm anteriorly and 3 mm posteriorly, collagen sponge and…
Post-extraction implant with crestal sinus lift and stabilization in the interradicular septum
Luca Boschini describes a post-extraction implant stabilized at the base of the interradicular septum. In his replies, he specifies a Neodent GM diam…
Graftless crestal sinus lift with Elevate: live surgery case
Michele Melillo presents a case performed entirely graftless with Elevate during a masterclass in Manfredonia, with an implant 5.5 h8.6 core 4.0…
Buccal root extraction with a customized Blexo Slim
MaciekIP reports extracting the buccal roots of a 7th tooth by bending the Blexo Slim. This is his personal experience.
Short press-fit implant with sinus lift in severe atrophy
Gianmario Scalvi presents a case with an Ornaghi 5x5 implant. In his replies, he describes using the 300 insert, bone harvested from other implant…
Extraction of 24 with Blexo and site preparation with Black Ruby
Carlo Marcato describes his first case with Osseotouch: extraction of 24 with Blexo and site preparation with Black Ruby.
Distal displacement of the sinus wall with Black Ruby
Francesco Benvenuto shares a small distal displacement of the sinus wall with BR. A discussion with Luca Boschini follows about whether the manoeuvre…
Graftless crestal sinus lift with the Mallet only: stable bone at the 8-year follow-up
Un simpatico caso eseguito solo con Mallet 8 anni fa
Severely carious, endodontically treated root with no coronal grip: extraction in 50 seconds followed by implant placement
Boschini explains why a severely decayed root that has already had root canal treatment can be difficult to extract, proposes applying force more…
Implants lost after piezoelectric preparation: overheating of the tip
Marcato suspects piezo-tip overheating after implant loss. A. R. responds with practical advice and personal experience; the discussion also covers…
Osseodensification with the Mallet: does it reduce vascularity and increase the risk of fibrous integration?
Carlo Marcato asks whether Mallet condensation could affect vascularity and favor fibrous integration. The discussion covers bone quality, an animal…
Fractured implants removed with the Mallet and replaced at once, together with an indirect sinus lift
Asnani removes fractured implants with the Mallet and places four new implants, two in the anterior sites just cleared. Asnani attributes…
Very difficult extraction with a conventional elevator: Blexo and Mallet in a few seconds
Melillo reports difficulty gaining access with conventional elevators. Melillo then chooses curved Blexo tips with the Mallet and describes an…
Sinus lift on 2 mm of bone after removing an orthodontic screw: a risky case
After removing an orthodontic screw, Melillo performs a sinus lift with Elevate on 2 mm of bone and places the implant. Colleagues discuss the risks…
Sinus lift with the Elevate kit on 2–3 mm of residual bone: expand and lift together
N. P. describes a sinus lift with Elevate on 2–3 mm of residual bone, combining expansion and elevation. When a colleague asks about the protocol, N…
Crestal sinus lift with a bone plug from 3 to 7 mm: bone core, instrument 300 and xenograft
L. B. describes a crestal sinus lift of approximately 7 mm with approximately 3 mm of residual bone, using a bone core and xenograft mixed with…
7 mm crestal sinus lift with the bone-plug technique on 3 mm of residual bone
Boschini describes approximately 7 mm of sinus elevation using the bone-plug technique, starting with 3 mm of residual bone. Colleagues ask about…
LMSF approach: changing the osteotomy direction by pushing the sinus wall
Melillo describes using the LMSF approach to change the osteotomy direction by pushing the sinus wall distally and explains the advantage Melillo…
Indirect sinus lifts at two sites in one session: hydraulic elevation at the FIRST upper molar and Mallet elevation at the SECOND upper molar
During a one-on-one mentoring session, N. P. uses a hydraulic Gdiff technique at the FIRST upper molar and the Magnetic Mallet at the SECOND upper…
Split crest and indirect sinus lift together: Genoa, Split, Elevate and Black Ruby
N. P. combines split crest and indirect sinus elevation, explaining the roles of Genoa, Split, Elevate and Black Ruby. N. S. then shares a separate…
Incisor chipped by the Mallet handle during extraction of tooth 48
G. reports chipping tooth 22 during extraction of tooth 48 and attributes the damage to recoil after contact between the Mallet handle and the upper…
Crestal sinus lift without collagen: it resorbs quickly and does not spread evenly
L. explains the reasons for believing that collagen can be avoided in a crestal sinus lift and describes the role L. assigns to the Magnetic Mallet.
Extraction and sinus lift with 3 mm of residual bone: a 4.5 × 7 mm implant with an intact sinus membrane
Starting with 3 mm of residual bone, D. S. combines extraction, grafting, sinus elevation with the Magnetic Mallet and immediate implant placement.
Sinus floor lifted over the implant apex: predictable bone formation
S. R. considers the Mallet crucial to the sinus lift and links displacement of the sinus floor above the implant apex to what S. R. regards as…
CBCT-based treatment planning: conventional implants, PSI or All-on-4
A. T. asks how to approach the case and shares a PDF after a request for the CBCT report. P. W. suggests several implant options, assuming good bone…
Full-arch rehabilitation: displacing the sinus walls to obtain the most distal implant emergence
In a full-arch rehabilitation, Melillo describes maneuvers along the sinus walls to obtain remote anchorage and a more distal implant emergence…
All-on-4 in extremely narrow ridges: full-arch mandibular split crest in D1 bone
Patel presents an All-on-4 case in very narrow ridges. For the lower arch, Patel reports a full-arch split crest with the Mallet and expanders…
Pterygoid or merely tilted? It cannot be determined from a panoramic radiograph alone
D. C. and N. P. discuss whether a tilted implant should be called pterygoid, referring to position, anchorage and the limitations of a panoramic…
Split in D1 bone: releasing cuts and pushing the wall without expansion
Patel distinguishes the presented posterior mandibular D2–D3 case from two other anterior D1 cases. Patel also explains the difference between…
Immediate implant in an upper first molar: interradicular septum with Elevate
Patel explains the preparation of the interradicular septum with Elevate, the choice of a 5 × 7 mm implant and the use of synthetic octacalcium…
Sinus lift with resorbable graft: new sinus floor at 1 and 2 years
L. B. compares the one- and two-year follow-ups and interprets the changes in the sinus floor. In reply to colleagues, L. B. specifies having used…
Split crest inserts: Cut as the first expander, then Exp 1-2-3A and the Genoa series
Amit Dhawan explains the roles of Cut, the Exp 1–2–3A expanders and Split, and mentions the Genoa series for more advanced splitting.
Freehand magnetodynamic full arch: distal emergence at position 5
Melillo presents a freehand magnetodynamic full-arch procedure with a microflap, aiming for distal emergence at position 5.
Posterior mandibular split crest with split inserts and Mallet expanders
N. P. describes a posterior mandibular split crest using Magnetic Mallet Split instruments followed by expanders. In reply to M. R., N. P. specifies…
First transcrestal mini sinus lift: sutures, Condress, hyaluronic acid or nothing
Gianluca is preparing a first transcrestal mini sinus lift and asks for advice on instruments and materials. Colleagues focus on ridge anatomy and…
Less than 2 mm of residual bone at site 27: an almost flapless crestal sinus lift instead of a lateral approach
At site 27, with 1.8 mm of residual bone, Melillo describes a crestal sinus lift using gel and Elevate through a small incision. At site 25, Melillo…
Implant placement at site 13 with a narrow ridge: guided buccal expansion
At site 13, with sufficient bone height but a narrow ridge, Tardani uses guided planning to choose the implant position and reports achieving buccal…
Flawless surgery—but was it the right choice for the patient?
D. A. acknowledges the quality of the surgery but questions whether the plan suited the patient when the whole quadrant is considered. L. B. assesses…
Immediate implant with a one-tap Mallet mini sinus lift and a bone dome over the apex
Boschini explains the choice of a small sinus lift during immediate implant placement, creating a bone dome around the apex, and then adds a second…
Fractured root with a bone defect: Mallet, GBR and simultaneous implant
P. describes extracting a fractured root with a bone defect, performing GBR and placing an implant at the same time. In the discussion of Mallet use…
Flapless extraction, sinus lift and immediate implant with autologous dentin
Pietro describes an extraction without a sulcular incision, followed by sinus elevation and immediate implant placement. In reply to T., Pietro…
Lower third molars: bone troughing, tooth sectioning and the Mallet on the roots only
For lower third molars, MaciekIP describes creating bone access around the crown and sectioning it before removing the roots with the Mallet…
Pneumatization between teeth 26 and 27: a gel-assisted crestal sinus lift instead of a lateral approach
With extensive pneumatization between teeth 26 and 27, Melillo chooses a crestal approach and uses Fisiograft paste for the first time. A colleague…
Guided surgery abandoned at site 23: Elevate, Black Ruby and a lamina secured with fibrin glue
M. places two implants with guided surgery but switches to the Mallet at site 23, using Elevate followed by Black Ruby. M. describes the graft…
Implant at site 26 failed to integrate three months after sinus lift: replacement and three-year follow-up
At three months, Melillo replaces the implant that failed to integrate at site 26 while reporting good healing after sinus augmentation. Melillo…
Radiographic halo around the implant: a not particularly effective implant design
Melillo describes replacing the implant at site 26 after three months but considers healing after sinus elevation favorable. The three-year follow-up…
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…
Follow-up CBCT after flapless implant placement: is it justified?
Lori objects to CBCT scans acquired solely to show cases; V. G. considers the low-dose follow-up scan after flapless implant placement justified…
4.8 × 10 mm implant with 15 mm of bone height: planning makes the difference
M. presents a 4.8 × 10 implant chosen with 15 mm of available bone height and expresses confidence in its strength. The plan also includes…
Intrasinus bone mass encountered during a sinus lift: sequestrum or osteoma? Histological examination and postponed treatment
DDM and W. C. suggest different explanations for a bone mass in the sinus. They discuss removal, postponing the lift and histological examination…
3 mm of residual bone at site 16 treated with Elevate and bone shaping of the septum at site 17: avoiding a lateral sinus lift
Franz presents a case planned and treated by Andrea: Elevate at site 16 with 3 mm of residual bone and bone shaping of the septum at site 17. The…
Failed socket preservation: anchoring to the sinus floor with Black Ruby
The initial bone graft failed to integrate. Boschini describes managing the site with implant placement and further bone regeneration, through to the…
Ankylosed tooth: after the initial movement the bone bridge re-forms
According to L. B., initial movement of an ankylosed tooth does not stop resorption: the bony bridge can re-form, and the process can affect the…
Transplantation of a partially ankylosed canine: an interim solution for a young patient
Luca Boschini transplants a canine with a small ankylosed area in a young patient, initially aiming for a temporary solution. Boschini reports better…
Tilted implants: reshaping the sinus with the Mallet, an immediate-loading case
Melillo describes repositioning an implant more distally to achieve a more distal prosthetic emergence and reports choosing immediate loading because…
Socket preservation with generous volumes and a buccal exostosis
This brief exchange centers on the volumes described by the participants and retains the lighthearted tone of the sharing.
Molars in dense cortical bone: drill first to make room, then the Mallet
Faced with very dense cortical bone around two molars, M. creates space with a bur before using the Mallet to extract the second.
Narrow ridge at 26: split crest and mini sinus lift through a single crestal incision
After an 83-year-old patient loses a bridge’s terminal abutment to caries, Melillo describes placing an implant in the narrow ridge at site 26, with…
Extraction in hard bone: drilling around and the Mallet, and the limits of reimplantation
The exchange separates access through very hard bone from replantation: an intact root and preservation of its ligament are not treated as equivalent.
Crestal sinus lift: graft or no graft? A protocol with more variables is needed
Michele Melillo discusses the criteria for choosing a crestal sinus lift and deciding whether to use graft material. In this case, Melillo uses…
Bone shaping on a thin ridge and crestal sinus lift with Elevate in the same case
In the same case, A. D. uses bone shaping on the narrow ridge at the mesial site and an Elevate crestal sinus lift at the distal site.
Guided sinus lift with Elevate and no graft: only collagen and native bone
V. presents a guided sinus lift with Elevate using collagen alone, without a particulate bone graft. P. E. shares a first experience with Elevate.
Sinus lift with 3 mm of residual bone: distal implant tilting or merely a projection artifact at six months
At the six-month follow-up, colleagues ask whether the implant has tilted or whether its appearance is due to the radiographic projection. Nicco…
Sinus lift using the bone-plug technique and the Mallet: 4.5 × 8 mm implants in 60 minutes
Filannino explains the sinus lift sequence and the decision to complete the operation despite the sinus width, based on what Filannino judged to be a…
Immediate implant in a molar with a 7 mm septum: septum expansion and slight sinus lift
With limited apical bone and a 7 mm septum, Melillo chooses to expand the septum for immediate implant placement and also reports a slight sinus…
Mandibular split crest: piezo cuts and a bone segment mobilized with the Mallet
Boschini describes mobilizing the buccal bone segment in a mandibular split-crest procedure and then answers questions about flap release and the…
LMSF at 6 months: better prosthetic emergence, straight abutment instead of a 30° MUA
Melillo presents the six-month follow-up of a case treated with LMSF and explains why the plan is to use a straight Octa abutment rather than a 30°…
Where to buy Condress online: online pharmacies at approximately €30
N. M. describes the online shops used to buy Condress and its price at the time of the conversation. M. O. asks whether an alternative is equivalent…
Condress unavailable in pharmacies: the equivalent alternative from VS Dental
This historical exchange moves from colleagues’ reports of availability to a suggested commercial alternative.
Crestal sinus lift with Elevate, hyaluronic acid and graft in a single surgery
The discussion focuses on implant position, stability in the remaining 3 mm of bone and anatomical case selection. Colleagues also discuss the…
Fully guided with the Mallet: TDC 5.15 sleeve or Dynamic kit and Conex implants
Scupilliti reports using Mallet tips with the TDC kit’s 5.15 sleeves and acknowledges some play in the pairing. T. suggests the Dynamic Kit with…
Crestal or lateral sinus lift? A lateral approach for a wide sinus with limited residual bone
Boschini explains the reasons for choosing a lateral approach for a wide sinus with limited residual bone. A colleague shares another case, and R. C…
Elevate kit in guided surgery: a few degrees of deviation between plan and CBCT
Tardani presents the use of Elevate in guided surgery as a technique still being tested, reports a deviation of only a few degrees between the plan…
Crestal sinus lift after extraction of tooth 16: a bone dome around the implant
After extracting tooth 16, L. B. chooses a sinus lift to allow implant placement and describes the operative sequence and the postoperative…
More clinical contributions
More experiences shared by colleagues.
Atraumatic extraction
Extraction of a partially ankylosed root: when to use drills
Carlo Marcato describes difficulties extracting a 36 and switching from Blexo instruments to drills. Colleagues share experiences and comments…
Sinus lift
Crestal sinus lift with a sinus-floor bone plug: osteotome and trephine only
Marco Montanari describes a crestal sinus lift achieved by elevating a sinus-floor bone plug with an osteotome and a trephine.
Sinus lift
Mini sinus lift with the Mallet and a dedicated kit: healing at 4 months
S. D. presents a mini sinus lift performed with the Mallet and a dedicated kit, with a healing assessment at four months.