Remove 8x14 mm Implant

A 61-year-old man has gingival hemorrhage from #14.  There are deep palatal pockets with bleeding on probing (Fig.1).  The large tissue-level implant was placed to replace a loose 6x11 mm one 7 years ago.  CT taken <2 years ago shows no palatal bone (Fig.2; periimplantitis).  Prepare 8/9 mm trephine bur, although it is most likely not appropriate because of its inherent abutment.  Draw 3 tubes of blood for PRF and sticky bone for bone graft.  The tooth #13 may need DO composite (Fig.1 *) or extraction.  The crown/abutment of #15 may be removed for easy access to #14. The abutment at #14 is 6 mm 10 degree, cemented with Ketac.  Prepare high speed handpiece to section the crown and make slot on the abutment and heat autoclave Husky Microdriver.

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Xin Wei, DDS, PhD, MS 1st edition 02/05/2020, last revision 03/21/2020