Narrow Long Implant in Reduced Edentulous Space

Bone expansion is not conducted at #5, since it is difficult to tap #15 blade.  When a parallel pin is placed 10 mm deep, the edentulous space at #5 is 5.5 mm mesiodistally (Fig.1).  After a 3.8 mm drill is used, the lingual plate is thin.  The narrowest 2-piece implant available (3.8x14 mm) is placed (Fig.2).  A 3.9x4(2) cemented abutment is tightened (Fig.3).  Fabrication of an immediate provisional is challenge in spite of proximal reduction of the neighboring teeth.  Reduced vertical height is a factor.  Periodontal dressing is applied around the cemented abutment.  One month postop, a healing abutment is placed (5.2x6.5(3) mm).  The implant appears to be osteointegrated 3.5 months postop (Fig.4).  A provisional is fabricated after placement of a cemented abutment (3.8x4(3) mm) to intrude the opposing tooth.  No bone loss is noted 2.5 years post cementation (Fig.5).

Return to Upper Arch, Premolar Immediate Implant, #14/15, 29, 2

Xin Wei, DDS, PhD, MS 1st edition 04/13/2016, last revision 06/12/2019