Immediate Implant for Periodontitis

A 52-year-old lady (ZJ) has severe bone loss at #3 (Fig.1 (CT sagittal section)).  After extraction, the socket will be treated with Metronidazole.  A small amount of apical bone is available for primary stability; the bone density is also low (300-500 Hounsfield Units, Fig.3 (axial section)).  Use RT2,3 for creating osteotomy and bone condensation, followed by 4.5-7x14 mm taps (11 mm deep; gingival margin).  Prior to bone grafting (Fig.1,2 (coronal section) red circles), apply Endogain against the root surface of the neighboring teeth.

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Xin Wei, DDS, PhD, MS 1st edition 10/25/2015, last revision 12/25/2018