Osteotomes for Early Implant

A 76-year-old man had the tooth #2 extracted (due to endo failure) 2 weeks ago (Fig.1).  The socket looks "empty" (Fig.2 S, basis for osteotomes).  It consists of the buccal (pink dashed line) and palatal (red) ones (Fig.3).  In one word, the socket is pyramidal.  It appears that a tapered implant is appropriate for the site.  Clinically, the socket is healing with soft tissue covering the opening of the socket. 

Use 4 mm implant spacer and RT2,3 to start osteotomy at the depth of 11 mm, followed by Tatum 4.5 and 5x14 mm taps at the depth between 11 and 14 mm.  Take PA with the tap with stability.  Prepare micro-osteotomes.

The smallest implant could be 5.3 mm (Fig.4,5).  The short (10 mm, Fig.4) and long (12 mm, Fig.5) may be below and above the sinus floor, respectively. 

If the stability of the 5x14 mm tap is not sufficient, insert 6x14 mm tap.  Extra wide implants will be tried, either 5.9 or 6.4x10 mm (SM, Fig.6) or 6 or 6.5x12 mm (UF, Fig.7).  An immediate provisional may be fabricated.

Return to Upper Molar Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 06/08/2015, last revision 06/17/2015