The 69-year-old male is a dental phobic with poor dentition. He wants to an implant at the site of #18 first and refuses to have the tooth #11 (with asymptomatic apical abscess) extracted. To reduce chance of post-implant infection, the implant is placed in a two stage manner. The distal amalgam overhang of the tooth #19 is removed by Piezo scaler (Fig.1). An incision is made. After a 2 mm pilot drill, a parallel pin is inserted; it appears that the coronal end of the trajectory should be leaned mesially (arrow). *: DO caries of the tooth #20.
Originally, a 5.3x12 mm implant is planned. A 2 mm pilot drill is used to initiate osteotomy 10 mm deep. In case the trajectory is not ideal, it is more easily changed than deeper osteotomy.
Since the ridge is wide, a shorter, but wider implant is placed (5.9x10 mm) for safety purpose.
Two Stage Next Xin Wei, DDS, PhD, MS 1st edition 01/09/2015, last revision 09/22/2018