Sufficient Bone Height

A 56-year-old man will return for #18 implant placement post 20, 14, and 29 ones.  Considering postop bone loss associated with delayed implant, an implant (13 or 15 mm long) at #18 is to be placed subcrestal (Fig.1 (pan taken when the implant was placed at #20)).

It is difficult to identify the Inferior Alveolar Canal when the initial osteotomy depth is 11.5 mm (Fig.2).  Following sequential osteotomy (last drills 4.5x11.5 and 4x13 mm), a 5x11.5 mm implant is placed with >50 Ncm (Fig.3,4).  Later the implant is placed .5 mm deeper with placement of a 6.5x4(4) mm abutment and autogenous bone lingually, in which ~.5 mm implant is uncovered.  There is mild bone loss distal 6.5 months postop (Fig.5).  Before cementation, the crown at #29 becomes loose.  The abutment screw needs retightening 6 months post cementation.  Six months post retightening, the abutment screw is loose at #14.

Return to Lower Molar Immediate Implant, Armaments Xin Wei, DDS, PhD, MS 1st edition 01/24/2018, last revision 09/04/2019