A 4.5x17 mm tissue-level implant is placed (Fig.3 I) with insertion torque >60 Ncm.  Allograft and Osteogen are placed around the bulging buccal and lingual plates (*).  Collagen membrane with a hole in the center is fixed around a 3.5x5 mm abutment (A).  An immediate provisional is fabricated mainly for wound protection and perio dressing fixation.

The patient returns 3 months postop; the bone graft appears to have been displaced mesioocclusally (Fig.4 arrow).

Fig.7: 7 months post cementation.

The chief complaint remains the same 1 year post cementation; mesial bone appears to form lamina dura-like structure (Fig.8 <).  Is this the earliest sign of periimplantitis?

Dense Bone Last Next Xin Wei, DDS, PhD, MS 1st edition 01/17/2016, last revision 01/19/2019