Soft and Hard Tissue Remolding after Implant Placement

Although there is enough bone to place 20 mm tissue-level implants at the sites of #29 and 30, revealed by CT examination (Fig.1-3), shorter and smaller ones are placed (Fig.4-6).  This apparently helps soft (Fig.7, 6 days postop) and hard (Fig.8, 2 months postop) healing.  The gingiva (Fig.9 *) appears to have attached to the implants by 2 months postop.  Definitive restorations are seated 4 months postop (Fig.10).  Thick gingival band (Fig.11 *) continues to attach to the implants 4 months post cementation, with formation of papilla between the implants.  Bone remolding post implant placement leads to the normal-looking rounded crest between the implants (Fig.12 arrowheads, as compared to the flat crest immediately post placement (Fig.6)).  His bone is type II, which is also favorable to healing post immediate implant.  To obtain favorable soft and hard tissue remolding, relatively small implants should be placed in high quality bone.

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Xin Wei, DDS, PhD, MS 1st edition 05/25/2015, last revision 01/19/2018