Initial osteotomies at the sites of #3 and 4 are parallel immediately post extraction (Fig.1); the buccal plate of the #4 socket is absent (*).

Immediate implants (Fig.3: 6x17 and 4.5x20 mm at #3 amd 4, respectively) obtain insertion torque > 60 Ncm.  Abutments are placed (5x3 and 3.5x3 mm).

The provisional is dislodged 3 months postop because of mobility and extrusion of the implant at #4 (Fig.6 with increased peri-implant space: *). There is no buccal concavity at #4.  After local anesthesia, the implant is retightend until 20 Ncm.  The provisional is recemented.

Provisional Without Prep Last Next

Xin Wei, DDS, PhD, MS 1st edition 09/18/2015, last revision 05/20/2018