Immediate Provisional

A 5x10 mm implant is placed at #3 according to drill sequence except 4.5x10 mm drill having to be used (plan: underdrilling using 4.0x10 mm as the last one) because of dense bone.  Insertion torque is >50 Ncm.  Although the implant apparently penetrates the sinus floor (Fig.1), the bottom of the osteotomy is intact before implant placement.  In addition, the 12 mm bone trimmer does not touch the septal bone, while 2.2x8.5 mm drill starting to remove bone.  In spite of using the largest cementation abutment (6.5 mm), the buccal (Fig.2) and palatal sockets with bone graft (*) are exposed.  An immediate provisional (Fig.3 P) is fabricated for remaining socket closure.  The buccal gingiva appears to have receded relative to the abutment margin nearly 4 months postop (Fig.4).  The mesial crestal bone defect seems to be repairing (Fig.5 (*),6).  The abutment later changes to a 5.7x5.5(2) mm one with margin modification buccomesiolingually before impression.

Return to Upper Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Trajectory Xin Wei, DDS, PhD, MS 1st edition 11/26/2018, last revision 03/20/2019