Long Implant is Needed

A 46-year-old man has severe chronic periodontitis associated with bruxism.  The teeth #3 and 2 have been replaced with immediate implants (Fig.1,2).  Now the tooth 4 should be treated in the same manner.  Since there is sufficient bone with uneven bone resorption, a long bone-level implant is needed for primary stability (>13 mm).  Cuff length of the tissue-level implant is fixed, while there are different lengths of the cuff associated with bone-level implants.  Metronidazole is the antibiotic to be used for socket disinfection.  Intraop PA should be taken with the pilot drill or a parallel pin to avoid invading the neighboring root or implant.  Abundant bone graft is required (circles, Fig.2).

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Xin Wei, DDS, PhD, MS 1st edition 08/16/2016, last revision 12/12/2018