Splint or Not

A 54-year-old man is a heavy bruxer.  The tooth #15 has fractured mesiodistally asymptomatic for a few years.  Recently the crown of #14 implant is loose after 3-year functioning.  In fact the abutment (4.5 mm, 10 °) is separated from the implant.  The unipost is recemented with bonding.  A provisional is fabricated.

When the tooth #15 is extracted, the socket is treated with Metronidazole.  Probably a long and large implant will be used (e.g., 7x17 mm, as compared to 6x17 mm at #14).  Try to place the new implant as straight as possible so that a straight unipost will be used to reduce the chance of unipost loosening due to long term and heavy mastication.  If primary stability is high, splint #14 and 15 provisional.  Otherwise make #14 one with full occlusion and #15 one with infraocclusion.  Last week root canal therapy was done at #4.  If he masticates mainly on the right, the tooth #4 may be prematurely fractured.

If the crestal bone is severely uneven, use a SM implant instead.

Return to Upper Molar Immediate Implant 31

Xin Wei, DDS, PhD, MS 1st edition 06/24/2016, last revision 12/16/2018