The third step to avoid paresthesia is called no drill osteotomy.  When the tooth is extracted, the depth of the socket is measured.  Tap(s) will be used to create the osteotomy (to form threads); the depth is controlled with precision.  The diameter of the implant is large enough to obtain primary stability.  Oversized implant may also injury the loop.  It is estimated that a 5x11 mm tissue-level tapered implant will be used (Fig.5) or 4.5x11 mm.  Mesiodistally the implant should be a little larger than the root, since buccolingual width of the socket is larger.  The osteotomy will be as lingual as possible, since the mental loop is buccally located.

This PA may be tilted, since preop panoramic X-ray shows that there is clearance between the root tip and the mental loop.

Return to No Drill Osteotomy

Xin Wei, DDS, PhD, MS 1st edition 05/31/2013, last revision 06/01/2014