Fig.5 (Intraop): Bone graft can be placed prior to or after implant placement.  

The advantage of the bone graft first is that it is easy to place bone graft to the area where it is needed.  The potential disadvantage is that bone graft may interfere with implant placement because of limited visibility.

In fact, the implant is placed, followed by bone graft, in this case (demineralized cortical human allograft, Impladent).  Placement of bone graft is somewhat difficult.

There is always a gap between the immediate implant and socket wall.  If an immediate provisional is planned, the gap is sealed with thick gingival retraction cord so that Titanium shaving does not drop into the socket.  The shaving may interfere with osteointegration. 

After prep is done with fabrication of an immediate provisional, the cord is removed.  Bone graft is placed.  Finally the provisional is cemented with minimal Temp Bond.

Return to Longest Implant Last Next Xin Wei, DDS, PhD, MS 1st edition 01/18/2013, last revision 10/06/2018