Implant Placed Too Close to Defect
Low bone density is confirmed during osteotomy at #14 (6 months post socket preservation). Underprep is adopted: after use of 3.5x10 mm drill instead of 4.5x10 mm one, a 4x10 and 4.5x10 mm dummy implant are placed for bone condensation. When a 5x10 mm definitive implant is placed, it is unable to be paced to the depth. After use of 4.0x10 mm, the final implant reaches depth ~ 1 mm more than planned. But there appears no bone palatal to the implant clinically. Small-field CT is taken. In fact there is crestal bone palatal to the implant, but in small amount and in low bone density (Fig.1,2). The implant should have been designed to be placed more buccal (Fig.3 arrow). The implant also looks to be placed too close the root of the tooth #13, probably related to the rotation of #13 (Fig.4). Unfortunately the patient does not agree to have limited orthodontics.
Case of Buccal
Xin Wei, DDS, PhD, MS 1st edition 11/19/2019, last revision 11/19/2019