Osteotomy Depth Control

Two months post removal of a loose implant at #27 for the 2nd time, an incision is made.  The osteotomy has healed.  Initial osteotomy with 2 mm drill for 12 mm leads to sudden empty feeling in spite of lingual plate protection (Fig.1).  When the parallel pin is removed, a long explorer does not find the perforation.  Subsequent osteotomy depth is 8.5 mm.  A 3.8x8.5 mm implant is placed with >40 Ncm (Fig.2).  After 5 more turns of the implant, a healing screw is placed (Fig.3,4 *).  The wound is closed for infection control.  It appears that the previous failures are due to lack of depth control and micromovement (immediate loading).  The implant appears to have been osteointegrated 5 months 20 days postop (Fig.5).

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Xin Wei, DDS, PhD, MS 1st edition 04/07/2018, last revision 10/07/2018