Palatally-Placed 1-Piece Implants Heal

As planned, 3 mm (central incisors) and 2.5 mm (lateral incisors) 1-piece implants (Fig.1 I) are placed palatal (P) to the buccal plate (B). Insertion torque is >50 Ncm for all of the implants.  Only exception is that an angled (15°) implant is used at the site of #8.  Bone graft is placed palatally to cover the coronally exposed threads.

One month postop, the patient returns for follow-up: the gingiva heals around the implants (Fig.4).  In fact the splinted provisional has been loose for a while.  The patient is able to remove it for cleaning.  Fig.5 shows the provisional after occlusal adjustment and re-cementation. 

The patient returns for final restoration 5 months postop; there is mild bone resorption (Fig.6,7*).  The crown at #8 is slightly loose immediately post cementation.  The latter is transient.  The bone resorption does not get worse 15 months post cementation (Fig.8,9).  The buccal and palatal gingiva remains healthy (Fig.10,11).  The palatal crest (P) is more apical than the buccal one (B) at #7-10 16.5 months post cementation (Fig.12-15), although there is midbuccal fenetration at #7 and 10 (Fig.12,15).

Return to Upper Incisor Immediate Implant 1-Piece, #4, 30, Chinese, Atrophic Ridge Armaments

Xin Wei, DDS, PhD, MS 1st edition 11/06/2015, last revision 01/31/2021