Ridge Atrophy Associated with Non-Immediate Implant is Iatrogenic

When the patient returns for implant placement, the ridge atrophy at the site of #19 looks so saddening (Fig.1).  Incision has to be made for osteotomy, which looks central in the ridge mesiodistally clinically, but not radiographically (Fig.2).  The latter is not noted until a 4.5x12 mm bone-level implant is placed (Fig.3,4).  The discrepancy is due to the mesial inclination of the tooth #18, which gives rise to false impression. When a 5.8x4 mm cemented abutment is placed (Fig.5), the distal clearance is less than the mesial one.  The ridge atrophy seems to re-appear after suturing!

All of these difficulties are related to no adherence to the Principle of No (immediate) Implant, No Extraction.  Post extraction atrophy without immediate implant is iatrogenic.

Return to Lower Molar Immediate Implant Xin Wei, DDS, PhD, MS 1st edition 05/19/2015, last revision 12/09/2018