Placement Along Mesial Surface of Socket

After extraction of residual root at #4 with mesiopalatal subgingival margin (Fig.1), the mesiopalatal crestal bone loss is noted.  Instead of the mesial slope, the initial point of the osteotomy is at the mesial and middle (buccopalatally) of the socket bottom (Fig.2, 2').  The initial depth with 2 mm drill is 20 mm (gingival level), while the last drill (3 mm) is used for 17 mm (because of soft bone).  When a 3.8x16 mm implant is placed (Fig.3,4), the distal gap of the socket is closed, suggesting that the implant moves to the least resistant area.  However, it is favorable to the mesial crestal defect (Fig.4).  The buccopalatal position of the abutment (4.5x4(4) mm) is a little too palatal (Fig.5, taken prior to provisional fabrication).  The implant seems to have osteointegrated 6 months postop (Fig.6).

Return to Upper Premolar Immediate Implant, IBS, #14, 24, Chinese

Xin Wei, DDS, PhD, MS 1st edition 08/21/2017, last revision 04/05/2018