Bone Graft Post Immediate Implant Exfoliation

Two months post immediate implant at the site of #2 (immediate provisional splinted to provisional at the site of #3), the patient returns with chief complaint of loose crowns.  Exam shows that the splinted restoration is loose and that the implant/abutment of #2 is mobile.  The latter is easily removed (Fig.1).  The site is debrided, copiously irrigated and soaked with Clindamycin.  Immediate re-implantation is not carried out due to poor bone density and large implant having been used (7x17 mm tapered tissue level).  Instead bone graft is placed immediately (Fig.2).

An implant will be placed in 4-6 months. 

The patient will return for implant re-placement 4 months post bone grafting.  An incision may be used for visibility.  Bone expansion is most likely needed.  A large cylindrical implant may act as a rescue one (such as 7 or 8x11 mm or UF (more like screw type)).  Take photos and PA preop.  Palpate the buccal and palatal walls before access.

Return to Upper Molar Immediate Implant, Posterior Immediate Provisional, Implant Failure, Dr. Wu

Xin Wei, DDS, PhD, MS 1st edition 03/29/2015, last revision 07/06/2015