Narrow Implants for Upper Central Incisors

A 51-year-old man has history of trauma to the tooth #9, which turns yellow.  Recently the tooth #8 becomes symptomatic.  The roots of these incisors are short (Fig.1).  One of them has a fractured root tip.  The extraction sockets (treated with Clindamycin) are shallow in bone and deeper in the soft tissue (Fig.1: 5.89 mm).  Cut gauze in proper size.  Use Bicon 2 mm pilot drill for 14 mm (buccal gingival margin), insert calibrated parallel pins and take PA.  If necessary, extend osteotomy to 17 mm, followed by 2.5 mm reamer at 14 mm and 3 mm reamer at 11 mm.  Lean drill/reamers as palatal as possible.  Insert 3.8 or 4.1x14 mm SM implants, at least 3 mm apical to the midbuccal gingival margin.  Choose cemented or temporary abutments (narrow) for immediate provisionals. Tighten fixation screws more securely.  The patient will soon leave for home country and will not return for a while.  Take preop photos to show discoloration of #9 and occlusion.

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Xin Wei, DDS, PhD, MS 1st edition 11/21/2015, last revision 02/14/2019