Extraction turns out to be easy in spite of subgingival fracture of the tooth (socket shield not indicated).  The buccal plate is intact.  Initial osteotomy is off with perforation of the nasal floor (Fig.2).  The trajectory is changed with Lindamann bur (Fig.3).  When the buccal plate is intact, the bone buccal to the implant is most likely regenerated so that there will be enough soft and hard tissue to cover the metal shade abutment.  On the other hand, the abutment metal may show through the thin crown if the implant and/or abutment are placed too buccally.

Metal Shade Abutment Last Next

Xin Wei, DDS, PhD, MS 1st edition 10/10/2017, last revision 08/15/2018