Curved Root

A 34-year-old man (smoker, half a pack a day) has residual root at #5 (Fig.1) with large periapical radiolucency (Fig.2 red dashed line).  Since the root curves distally (Fig.3 black area, Clindamycin), osteotomy will be established in the mesial wall (red long arrow).  A 3.8x16 or 18 mm implant is to be placed for primary stability (Fig.4).  To reduce periimplantitis associated with smoking, place the implant deep.  The implant appears to have better surface treatment.  Pack sufficient bone graft and membrane.  Immediate provisional should have good seal.  To place the implant deep, osteotomy will be attempted with a long 1.5 mm pilot drill (PA), followed by 2 mm one with extension and 3.0x18 mm drill.

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Xin Wei, DDS, PhD, MS 1st edition 03/10/2017, last revision 01/19/2018