Mixed Bone Graft

Since the tooth #31 is mesially shifted and tilted with mobility, it would not be a good distal anchor tooth for #30 implant placement with a surgical guide.  It is extracted when an implant is placed at #3 so that autogenous bone harvested from the osteotomy at #3 will be mixed with allograft (Vanilla) and alloplast (Osteogen) for #31 socket preservation (Fig.3 M).  After Osteogen plug and 6-month membrane are placed over the mixed graft, the socket is approximated with 5-0 PGA (Fig.1,2).  The 6-month membrane appears to be retained 5 days postop (Fig.4).  The socket reduces substantially nearly 1 month postop (Fig.5,6).  The small 2nd molar socket (as compared to the 1st molar one) heals quick.  PGA suture should be used more often (for more cases and repeat multiple times for secure closure).  The bone density in the graft area increases 4 months postop (Fig.7).  The graft remains in site nearly 11 months postop (Fig.8).  The ridge #30 will be split with guide.  In fact there is not much problem when the osteotomy moves lingual.

 Return to Lower Molar Immediate Implant, Trajectory II 种植 Xin Wei, DDS, PhD, MS 1st edition 09/20/2019, last revision 10/20/2020