Implant Placed 2 Weeks Post Extraction

A 49-year-old lady is supposed to return to have an implant placed at #30 (Fig.1 panoramic image from CT).  She happened to visit another dentist's office for free cleaning ~ 2 weeks earlier.  The tooth #13 was extracted (without socket preservation) because of mobility.  This patient is petit and has tendency to have bone resorption after extraction (#14, 19).  Exam reveals that there is no bone loss at the site of #13.  After discussion, she agrees to have an early implant to be placed at #13 first (Fig.2: CT coronal section).

Osteotomy is finished with osteotomes, drills (Fig.3 parallel pin) and tap (Fig.4: 4.5x17 mm at 14 mm deep).  The tap is placed in the palatal portion of the healing socket (Fig.5 (B: buccal).  When the tap is removed, the osteotomy site remains palatal (Fig.6 O).  After adjustment of mesiodistal trajectory, a 4.5x14 tissue-level implant is placed (Fig.7).  An abutment is placed for an immediate implant.  The patient and her friend are surprised to find out that there is no bleeding.  There is no pain postop.

The patient will return for final restoration 2.5 months postop.  The provisional has had occlusal perforation.  After the provisional is removed, the implant/abutment will be reprep.  Instead of taking impression, the provisional will be modified or fabricated first.  If it is cosmetically ideal, the impression will be taken.  If not, cement the provisional so that the buccal gingiva will be pressed to form normally.  Take photos for each step.

Return to Upper Bicuspid Immediate Implant, Posterior Immediate Provisional, #14 14/19 Guide Xin Wei, DDS, PhD, MS 1st edition 11/18/2015, last revision 07/27/2018