Underprep

Last visit, a 76-year-old lady found that the tooth #24 was mobile.  After #25 implant crown recementation, occlusal equilibrium was done so that occlsual force/contact was transferred from #24 to #25.  Two weeks later, the tooth #24 mobility is reduced.  The patient wants to crown the rest of the lower anterior teeth.  After discussion, she agrees to restore the posterior teeth first.  PAs and impression are taken (Fig.1-4).  When the implant was placed at the site of #20 (Fig.1), the bone was found to be soft.  To obtain primary stability, osteotomy at #18 and 19 will be under prepared (one size smaller).  The immediate provisional at the site of #20 is oversized mesiodistally.  Before surgery, it should be trimmed as shown in Fig.4 red dashed line.  The 3 implants are to be splinted.  No localized use of antibiotic is for this case, since these 2 teeth have been missing > 6 months.

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Xin Wei, DDS, PhD, MS 1st edition 08/23/2015, last revision 12/26/2018