Underprep and Undersize

A 52-year-old woman is petit in stature and partially edentulous.  Since the implant at #13 is distally placed (with a temporary crown in place after abutment screw retightening), the implant at #14 should be placed as mesial as possible.  The initial osteotomy should be 12 mm from the distal surface of the tooth #12 (Fig.1).  Secondly the osteotomy should be underprep because of low bone density (160-240 Units, Fig.2).

The bone height at #19 (Fig.3) allows placement of a 4x7.3 mm equicrestal or 5.5x5 mm subcrestal (Fig.4).  A 4x8.5 mm UF implant (DIO, 1-staged ridge split) at #30 has been functionally 2 years 2 months post cementation.  Since PVS impression for guide does not catch anatomy twice, Alginate impression will be taken for wax up and surgical stent.  Use surgical handpiece and DIO Bone Expanders for 4x7.3 mm implant.

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Xin Wei, DDS, PhD, MS 1st edition 07/27/2018, last revision 08/19/2018