2 Immediate Implants with Different Approaches

The teeth #14 and 18 of a 46-year-old man become symptomatic 1 month after #4 implant placement.  While the socket at #14 is shallow, the apical bone is abundant (Fig.1).  The longest IBS implant should be safe (13 mm, Fig.2).  In contrast, the socket at #18 is relatively deep, the apical bone is short (Fig.3).  A shorter implant (11 mm or less, Fig.4) should be chosen.  Osteotomy in the new bone should be 4 mm.  Try in a 5x9 mm dummy implant at #18.  No antibiotic is used for socket treatment.  The bone density in the mandible should be high (drills), whereas that in the maxilla may be low (expanders) or medium (drills).  Preop exam will decide which tooth needs treatment first.  Take photos PRN.

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Xin Wei, DDS, PhD, MS 1st edition 10/17/2016, last revision 10/18/2016