Bone Expansion at Septum
A 46-year-old woman has apical periodontitis with distal crack line at #14. There are 2 fistulae (buccal and palatal). A gutta percha is inserted into the buccal one (Fig.1 <). After extraction and Xylocaine gauze application in the socket, use 1.6 mm pilot drill in the septum for 7 mm, followed by Magic split and expanders for sinus lift. Place a relatively small implant (IBS, 4.5x13 or 5x11 mm, Fig.2) in the septum or a large one (6x13 mm or 6 mm 1-piece one, Fig.3) to obliterate the whole socket.
To reduce implant micro-movement initially and increase crown retention later, choose a short abutment for immediate provisional and a longer one for final restoration if necessary. The diameter of the abutment should be as large as possible.
Return to Upper Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), IBS Xin Wei, DDS, PhD, MS 1st edition 07/30/2016, last revision 06/03/2018