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A bone-level implant is barely able to be placed with guide; it is parallel to #19 implant (Fig.2). Full guide is necessary. Pre- and intra-op exam confirms periimplantitis at #19. In addition the horizontally impacted #17 has caries. A large incision is made for #19 debridement and bone graft. #18 bone graft (Fig.2 *) and #17 extraction and Osteogen plug (O) placement. The healing screw at #19 is a mismatch.
Xin Wei, DDS, PhD, MS 1st edition 02/10/2020, last revision 02/10/2020