Change Trajectory

Two and a half months after removal of malpositioned implant at the site of #12 (photos to be taken to show healed socket), a 1.5 mm sharp pilot drill (Tatum, long) will be used (Fig.1 red line) to penetrate the distal slope of the previous osteotomy (photo to be taken).  Once the lamina dura is penetrated, the trajectory of the drill is straightened up and deepened until 14 mm from the gingival margin (Fig.2).  A 1st intraop PA is taken to confirm the position of the new osteotomy relative to the neighboring structures.  If it is correct, deepen the osteotomy until 20 mm (Fig.3) so that it is less likely to be deviated mesially when the diameter of osteotomy is increasing and when an implant (probably 4x20 mm) is being placed.  Lean the bur, reamer and implant distally while going deep.

Return to Upper Premolar Immediate Implant 前磨牙即种

Xin Wei, DDS, PhD, MS 1st edition 10/18/2015, last revision 05/02/2021