A Short Implant Placed in the Septum

A 69-year-old man has pain in the tooth #19 (Fig.1).  When a rubber dam clamp is placed for retreatment, the crown falls out (Fig2).  Due to short clinical crown, the tooth is deemed non-salvageable.  Fig.3 is an illustration after extraction.  It seems that the septum is wide at the base.  Measure socket depth.  An osteotomy will be 1 mm longer than the socket depth (Fig.4).  The osteotomy is initiated in the middle of the septum 14 mm deep.  Insert a shortest parallel pin for occlusal check and a 14 mm long parallel pin for X-ray.  Change trajectory if needed.  A 5x14 mm tissue-level implant or 12 mm bone-level implant will be placed to prove that a short implant can achieve primary stability mainly by engagement into the septal struts and ~ 1 mm into apical new bone.  With 2 roots distally, the position of the immediate implant will be affected?

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Xin Wei, DDS, PhD, MS 1st edition 05/16/2015, last revision 05/18/2015