I graduated from dental school 10 years ago and have taken Arun Gargs implant seminars maxi course to learn implants and his weekend seminar on grafting.
I have a piezo in my office but no matter what I do I tear the membrane over and over. I repair with a membrane but my patients usually have alot of pain and swelling. The overall graft results are usually poor with often having trouble placing the implants.
What can I DO TO IMPROVE????

How can I control the bleeding from superior posterior alviolar artery during sinus window opening ?? Is there a way to avoid this issue? Will the balloon help avoid this?

A patient recently came to my office wanting to get rid of her dentures. 
Which is a better solution for the upper arch: A sinus lift with 8 implants or bilateral zygoma implant with 4 implants?
What are the risks of zygoma implants?
Is there long term studies showing success?
How is the sinus adversly affected by putting the implant through the sinus?

I recently placed 2 immediate implants in the position of the lower right bicuspids. I had placed a small concurrent graft and covered with a resorbable membrane and a cytoplast non resorbable membrane on top. I removed the sutures which were mostly gone 2 weeks later and the incision line was open by 4 mm or so. I think the cytoplast sprung the wound open. It is healing by secondary intention and at this stage looks like a wide ridge in that area. Should I expect any long term problems from this and will the ridge likely narrow as it heals ?

Thanks

Brent

hello
i placed four implants in edentulous mandible anterior region, 4.3 with 15 mm ,but one just failed without any obvious reason ,i removed it and placed pt on some
antibiotics,as there was a periapical infection below the implant in panorex
i want to replace that implant ,please advise how to proceed,
i can post panorex on your website for you guidance ,pt is 65 year old without any systemic cause bone density is D3 i want to give him an i
implant retained overdenture

i wanna ask some questions about plastic surgery around dental implants :
1) Are there rules or protocols of optimizing the soft tissues buccal to the dental implant is it important whether there is soft tissue defect buccally or not ?
2) How can I estimate that this area need soft tissue augmentation in cases of mild defects ?
3)What is the acceptable width of keratinized tissue around dental implant beyond which the gingiva must be harvested ?
4) Does this width differs in anterior implants from posterior implants ?

Since experimental fracture tests on endodontically treated teeth with porcelain restorations show that even in fracture, the dentin bond survives and the tooth breaks instead, in what way do you think this may alter the dynamics of biologic width invasion or crown lengthening procedures?

And if a bonded margin is subgingival (and therefore no marginal gap, assuming isolation during the bonding), and there is no microenvironment for bacterial colonization, does that alter our perception of biologic width compromise as it does with a cemented crown with it's inherent marginal gap?

I typically what 4-6 months before letting my restorative dentist restore the implants. What is the besr way to determine if the Implants are Osseointegrated and ready to be restored?

I have a patient with missing molars on the right side of the maxilla. I did a Cone Beam CT I discovered a lesion that looks mucous retention cyst.
The lesion occupies over 40% of the right maxillary sinus. I referred the patient for surgical removal of the lesion with ENT specialist. The ENT refused to do the surgery. He stated that according to ENT guidelines this kind of lesion does not require any treatment if asymptomatic, and that success of sinus graft will be decreased due to this lesion. He reommended not doing the implant.
What should I do?