The patient return for re-evaluation in 3 months (15 months postop); radiolucency appears to reduce (Fig.14).  But there is pain when the healing abutment is being removed.  After local anesthesia, the implant is removed with a wrench.  Following debridement of the osteototomy (intact, although tender), a 5x10 mm dummy implant with SLA surface is placed (Fig.15).  After 5.5 mm tap, a 5.5x8.5 mm implant is placed with >50 Ncm (Fig.16).  A 6.8x5 mm healing abutment is placed, followed by periodontal dressing.  Re-analysis of preop CBCT shows that the bone density at the site is low: 70 units average.  Progressive loading is necessary for this case 4-6 months postop.

Mesial Socket Placement Last Next

Xin Wei, DDS, PhD, MS 1st edition 04/25/2018, last revision 08/30/2018