Difficulty in Placing Non-Immediate Implant M
Placement of the non-immediate implant at the site of #14 turns out to be extremely difficult from the very beginning partially due to the distally curved root of the 2nd premolar (Fig.1: parallel pin). With effort, the trajectory is corrected to certain degree, but not the position (Fig.2). When a 4.5x11 mm tap is inserted (Fig.3,4), it appears that the osteotomy cannot afford to increase in diameter too much, although there is enough bone buccopalatally. A 5x11 mm implant is placed with insertion torque > 60 Ncm (Fig.5). Autogenous bone and Osteogen is placed distolingually. A provisional is cemented 2 weeks postop. The implant appears to be osteointegrated 3.5 months postop (Fig.6). A permanent crown is cemented 5 months postop. There is no bone loss 1 year 7 months post cementation (Fig.7). With non-immediate implant at the first molar, the trajectory may be inadvertently not ideal, but the position may not be corrected to large degree. With taking early intraop PA with a parallel pin, trajectory issue is avoidable. The immediate implant (6x14 mm) is always larger and longer than non-immediate one (5x11 mm) for the same patient. Return to Upper Molar Immediate Implant 19 Xin Wei, DDS, PhD, MS 1st edition 05/04/2015, last revision 12/26/2019