Possible Deciduous Molar Retention

The wide mesiodistal space at #29 is most likely due to congenital missing permanent tooth (i.e., deciduous molar retention before extraction 34 years ago).  The patient is now 62 years old.  In fact the buccolingual width is not so narrow (Fig.1).  After incision, the ridge is approximately 5 mm.  Two osteotomies are established with 1.2 mm drill at 8 mm mesially and 1.5 mm one at 10 mm distally (Fig.2).  The apparent approximation of the mesial osteotomy to the Mental Loop (red dashed line) is related to X-ray angulation, since there is 1-2 mm separation when two of 2x10(2) mm 1-piece implants are placed (Fig.3,4).  Insertion torques of the mesial and distal implants are less than 25 and 15 Ncm, respectively.  In fact bone graft is placed around the distolingual root of the tooth #30 after calculus removal (Fig.4 <).  Following reduction of the abutments, periodontal dressing is applied locally.  The dressing dislodged 13 days postop (Fig.5).  A provisional is going to be fabricated 4 weeks postop when the wound heals (Fig.6).  No bone loss is observed 4 months postop (Fig.7).

Return to Lower Premolar Immediate Implant, IBS, 1-Piece, Chinese

Xin Wei, DDS, PhD, MS 1st edition 03/03/2017, last revision 06/02/2018