Bone Expanders Through Guide

A 54-year-old man returns for #28 and 31 implants 3 months post extraction (#8,9 implants 4 years 5 months post cementation, Fig.1).  The buccal plate at #28 is concave (Fig.2 *).  After 2.2 mm drill to the depth as lingual as possible (Fig.3 L), use bone expanders through the guide to push the buccal plate out.  Use Magic split or bone scalpels and blades to facilitate the expansion if needed.  Place mixture of autogenous bone from #18 (Fig.4) and allograft buccally before implant insertion.  Vertical fracture of the mesial root at #18 is an incidental finding (Fig.5 M).  To avoid the impacted 3rd molar, osteotomy will be initiated as mesial as possible (Fig.6).

Return to Lower Molar Premolar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Trajectory II , Clindamycin Metronidazole No Antibiotic 8/9
Xin Wei, DDS, PhD, MS 1st edition 07/01/2019, last revision 07/26/2019