Subgingival Caries of 2nd Lower Molar

A 29-year-old woman has severe toothache associated with #31 subgingival caries (Fig.1 *).  The affected tooth will be extracted prior to #32.  Pointed/Lindamann bur with 4 mm stopper will be used to initiate osteotomy in the mesial socket of #31.  Following 2.2 mm drill with the same stopper, insert marked parallel pin for PA.  While Osteogen plug is going to be used to pack #32 socket and 31 distal socket (apical half), Vanilla graft with Osteogen will be used to fill the coronal portion of #31 socket.  Suture may be used to close #32 socket if the immediate provisional at #31 fails to do so.  In fact, no immediate implant is placed.  The tooth: 32 socket receives a piece of 10x20 mm OsteoGen Plug, while #31 one Vanilla Cancellous/Cortical Mix with Osteogen (Fig.2 *), covered with Osteogen plug, 4-0 Chromic gut suture (figure-8 and interrupted), 2x2 gauze, hemastatic.  The sockets heal nearly 5 months postop before the patient returns to her home country for living.

Return to Lower Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Trajectory, No Antibiotic

Xin Wei, DDS, PhD, MS 1st edition 05/30/2018, last revision 10/21/2018