Buccal Placement

After extraction of the tooth #14 with palatal root fracture (Fig.1 <), sinus membrane perforation is found in the buccal wall of the palatal socket (Fig.2 ^).  Osteotomy is initiated in the buccal strut of the septum (Fig.3 *).  As the osteotomy increases in diameter, it slides into the mesiobuccal socket (Fig.4).  A 5x9 mm implant is placed slightly mesial; after placement of a 6.5x4(2) mm abutment and insertion of collagen plug in the palatal socket, Vera graft is placed in the remaining socket space (Fig.5 *).  Nasal hemorrhage persists 1.5 months postop (Fig.6).   The distal gingiva is slightly tender and erythematous; a 6x4 mm healing abutment is placed 2.5 months postop (Fig.7,8).  Impression is taken after laser gingivectomy 3.5 months postop.  The patient feels discomfort at the site 7 days post impression, although the gingiva heals after laser treatment.  Two weeks after cementation, the mesial gingiva is mildly tender and the abutment screw is loose.  A 6x3 mm healing abutment is placed.  The abutment/crown is reseated 10 months postop (Fig.9).

Return to Upper Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Armaments 1 2 3

Xin Wei, DDS, PhD, MS 1st edition 12/11/2017, last revision 12/09/2018