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Since the implant is malpositioned and oversized, it should be removed. Prepare Dialite bur(s) and crown removals. After Metronidazole treatment and irrigation, a new osteotomy site is gained mesially (Fig.8 red arrow). Once bony entrance is obtained, change trajectory (Fig.9). Use 5 mm stopper and 2 mm pilot drill from Sinus Master Kit, followed by the smaller round drill to obtain proper depth. When the smallest UF implant achieves primary stability (Fig.10 green), try the largest cemented abutment. Then remove the latter, insert a piece of cotton pellet into the implant well, and pack bone graft until the platform of the implant (Fig.10 pink). Remove the cotton pellet, tighten the abutment, place more bone graft around the abutment until its margin and fabricate an immediate provisional to seal the defect opening. Also prepare Emdogain so that bone may form over the exposed root of the tooth #2.
Xin Wei, DDS, PhD, MS 1st edition 02/28/2016, last revision 02/28/2016