Determine Cuff First

A 71-year-old man requests implant replacement for the lower left lateral incisor, which is discolored and mobile with large periapical radiolucency (Fig.1 arrowheads).  The distal crest is lower than the mesial one, which remains the same postop.  After extraction (Clindamycin), measure the depth of the gingiva (Fig.2 pink line) to determine the cuff of 1-piece implant (most likely 3x16(4) mm or 2.5x14(4) mm).  Load 2% Xylo 1:50,000 Epinephrine for intraligamental injection.  Take PA after 1.2 mm drill.

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Xin Wei, DDS, PhD, MS 1st edition 05/28/2017, last revision 08/16/2019