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Recently the tooth #24 fractured equigingival (Fig.2 saw-toothed line). The edentulous area at #25 is narrow buccolingually. Start osteotomy lingually. As the osteotomy increases and a 2 or 2.5 mm 1-piece DIO implant is placed, the weaker buccal plate is being expanded buccally.
A 3 or 3.5 mm 1-piece implant is placed at #24 after Metronidazole socket soaking. The larger one is chosen (3.5 mm (Tatum)) if the implant at #25 fails to be placed. A dummy implant is placed partially to test trajectory. If the latter is bad, use an angled 1-piece one (Tatum). The composite overhang (Fig.2 *) is to be trimmed (Fig.3 red line).
Encourage the patient to floss, since there was caries between #23 and 24.
Xin Wei, DDS, PhD, MS 1st edition 07/26/2016, last revision 07/26/2016