A 40 year old male with missing 14 (Right first premolar), 16(Rt 1st Molar ) , 24 to 27 (left first premolar to second molar ).He was wearing bridges but had problem of food lodgement and caries in abutment tooth . A CBCT was planned and bone was deficient on both sides . On left side only 2 mm bone height was there ,and on right side also around 6.8 mm bone height was there . Also Ridge was only 4.1 mm wide in right first premolar region . 1)A Direct sinus lift was done on 26 and 27 region with biooss graft with bioguide membrane and a titanium mesh attached to implant cover screw was placed to prevent dropping into sinus as the bone height was only 2 mm .
2)Indirect sinus lift was done on right first molar . 3)Ridge split was done on right premolar . Neobiotech implants were placed .Re CBCT confirmed 3D around implant . Open tray impression made with polyether and screw retained prosthesis given.
