A 34-year-old man has persistent large periradicular radiolucency after root canal therapy with a fistula (Fig.2).  It appears that immediately after extraction (no Antibiotic) a long implant (15 or 16 mm, green outline) should be placed to bypass the bony defect with 2-point fixation (septum and sinus floor; Fig.3 (CBCT sagittal section) red line).  A shorter implant, which is placed at the septum (4-5 mm tall), is not expected to be stable.

Bypass Defect

Xin Wei, DDS, PhD, MS 1st edition 02/11/2017, last revision 02/11/2017