Immediate vs. delayed Implants

Immediately post-extraction at #4, a 2 mm pilot drill is used to initiate osteotomy (Fig.1).  Finally a 4.5x14 mm implant (I in Fig.2,3) and a 4.8x4(6) mm abutment (A) are placed.  An immediate provisional is fabricated.

At #6 (atrophic ridge), the 2 mm pilot drill is used (Fig.4), followed by 3.8x14 mm drill (Fig.5 D).  A 4.1x14 mm implant and a 3.9x7(4.5) mm abutment are placed (Fig.6 I).  An immediate provisional is also fabricated.

Four weeks postop, the patient returns for follow up.  Both of the provisionals are in place.  He plans to have immediate implant at #19.

There is no bone resorption 3 months postop (Fig.7,8).  Impression is taken with lower anterior implants.  The major issue is that the implant at #4 is close to the tooth #5.  Prior to impression, the mesial surface of the abutment at #4 is reduced with enameloplasty of the tooth #5 (Fig.8 red lines).  A smaller implant should have been placed in a narrow space.

Return to Upper Canine, Premolar Immediate Implant, Lower Arch Reconstruction

Xin Wei, DDS, PhD, MS 1st edition 12/05/2015, last revision 02/17/2016