Achieving primary implant stability is essential for successful osseointegration and long-term implant success. Stability at the time of placement is largely influenced by the quantity and quality of available bone. The posterior maxilla often presents challenges for implant placement due to factors such as sinus pneumatization and relatively low bone density, making it a less favorable site. This case report describes the treatment of a 45-year-old female patient with missing upper left second premolar and first molar. Radiographic assessment revealed sufficient bone in the premolar region, allowing for conventional implant placement. However, the molar region exhibited reduced bone height and D3 bone quality. To overcome these limitations and achieve adequate primary stability, osseodensification was performed using specially designed Densah burs™, which enhance bone density through a non-excavating, compaction-based drilling technique. A 4.0 × 8.5 mm implant was successfully placed in the molar area following indirect sinus lift via osseodensification, while a 3.5 × 10 mm implant was conventionally placed in the premolar site without sinus elevation. Healing was uneventful, at the end of 6 months follow-up, and final prosthetic rehabilitation was completed using screw-retained porcelain-fused-to-metal crowns. This case underscores the effectiveness of osseodensification in improving primary stability and expanding treatment options in anatomically challenging sites like the posterior maxilla.
Keywords: Sinus elevation, Maxillary implant, Densah bur, Indirect sinus lift
