Implant in Narrow Pontic

A 59-year-old lady had a brain stem tumor removed ~ 20 years ago.  The surgery left her tongue paralyzed (cranial nerve #12).  She mainly chews on the right side.  Porcelain has been chipped from #2 crown and #3 retainer.  Treatment plan includes removal of #4 pontic (Fig.2 CT coronal section (B: buccal)), implant placement (Fig.1), and crown placement at #2-4 once the implant osteointegrates.  Since the ridge at #4 is narrow buccopalatally, a 3 mm 1-piece angled (15°) implant is to be placed.  Use the corresponding 3 mm tissue punch for access after palpation of the ridge.  Bone density in the area is low (-300 to 300 Hounsfield units).  Underprep is a must.

Return to Upper Premolar Immediate Implant Xin Wei, DDS, PhD, MS 1st edition 11/08/2015, last revision 08/02/2018