Incision reveals that the ridge at #9 and 11 is narrower than expected.  A 3x14 mm 15º 1 piece implant is placed at the site of #9, while a 3x17 mm straight 1-piece one is placed at #11 (Fig.4).  Insertion torques at #9 and 11 are 20 and 30 Ncm, respectively.  The position and trajectory of the implants are dictated by the partial denture and surgical stent.  After bone graft (^) and Osteogen Membrane, the ridge (Fig.3) is wider than before.

If PA were taken with initial drills, the length of the implant at #9 would be increased for higher insertion torque.  For lady with possible osteoporosis, osteotomy should be underprep.

Water Pik has been used since surgery, but it may be related to loss of bone graft 3.5 months postop (Fig.9 *).  The patient complains of pain when water touches the palatal gingiva at #9.  The implant should have been placed deeper so that there would be no thread exposure palatally.

Angled vs. Straight 1-Piece Implants Last Next

Xin Wei, DDS, PhD, MS 1st edition 04/15/2017, last revision 08/05/2018