Septum Placement

A 49-year-old man requests to restore #14 with residual roots (Fig.1).  There is periapical radiolucency (Fig.2 *).   A 5.9x10 mm bone-level implant is placed with minor sinus lift (Fig.3), whereas a short (Fig.4) or long (Fig.5) tissue-level implant is placed without or with sinus lift.  The implant could be as large as 7 mm (Fig.5) to prevent post-extraction ridge atrophy.

It appears that the palatal root (Fig.6 P) is separated from the buccal ones (MB, DB).  Connection between the latter appears to be weak (Fig.2) and could be broken using proximators or small straight elevator.

To place an implant in the center of the septum, the smallest pilot drill will be used for 6 mm.  Insert a parallel pin with millimeter marks and take the 1st intraop PA.  Change the trajectory if necessary.  Combination of reamers and osteotomes will be used to enlarge the osteotomy, followed by taps and an implant.

Return to Upper Molar Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 04/25/2015, last revision 04/27/2015