Place Implant Between Buccolingual Crests

A 59-year-old woman had the tooth #19 with apparently residual roots extracted in her home country ~ 6 months ago (Fig.1).  There seems to be severe bone plate resorption, with the buccal crest  (Fig.2 red dashed line) 7-8 mm lower than the lingual one (pink dashed line).  Following flap reflection, an osteotomy will be established between the crests (Fig.2 white circle).  A 4 or 4.5x10 mm implant with high stability (Fig.4 green outline) will be placed ~ 4 mm (yellow line) below the lingual crest and ~ 4 mm above the buccal one.  The implant is going to have > 5 mm in the native bone (pink).  It may have ~ 2 mm (red line) clearance from the Inferior Alveolar Canal.  Since the implant is most likely placed lingually, prepare the Planning Kit and an angled abutment.  Vanilla graft will be placed buccally, followed by PRF membranes.  One of the latter has a hole for the abutment to penetrate.

Since the tooth #18 seemingly tilts mesially, make a good provisional with normal occlusal and proximal contacts prior to impression to make sure no food impaction.

Return to Lower Molar Immediate Implant, Armaments

Xin Wei, DDS, PhD, MS 1st edition 02/17/2018, last revision 09/03/2018