The teeth #9 and 10 are extracted first; a 4x16 mm UF implant is placed at #9, while a 2 mm pilot drill is at the site of #10 (Fig.3). 

The implant at #9 is placed deeper with placement of 4.5x5.5(5) mm abutment (apparent too short above the gingiva); a 3.8x15 mm implant is placed at #10 initially (Fig.4).  There is pain when the implant at #10 is being placed in the end.  When the implant is removed, the apical end of the osteotomy feels soft (in the nasal cavity?).  The implant at #9 should have been placed mesially due to distal displacement of the tooth (misleading).  Guided surgery is preferable.

Bone loss at #11 is severe.  The tooth is extracted next with removal of the 5-unit FPD (#11-15).

Long Implants Last Next

Xin Wei, DDS, PhD, MS 1st edition 02/24/2017, last revision 03/02/2019