Why No Bone Loss after Immediate Loading?

To prevent implant thread exposure in a narrow ridge, open incision is preferable, but it may be associated with bone resorption.  The case presented here appears to have favorable results.

He is 55 year old with loss of the lower incisors for several years (Fig.1 CT 3-D image with stent (S)).  The ridge is wide enough to hold 3 of 3 mm implants (Fig.2, CT axial (transverse) section ). #15 scalpel is used to make entrance points through the gingiva, followed by 1.5 mm pilot drill at 17 mm (Fig.3) and 2 mm drill at 8.5 mm.  Two of 3x17 mm one piece implants are placed with the most coronal thread outside the crest (Fig.4,4').  No suture is needed post implantation because of small incisions (Fig.5 >); an immediate bridge is fabricated.  Note that the gingiva is thick with stippling.  Fig.6 is taken 5 months postop.  There is no crestal bone resorption 6 months post immediate loading with provisional (Fig.7).

The success of this case (almost no bone resorption) is probably related to wide ridge, thick gingiva and conservative incision.

Return to Lower Incisor Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 10/03/2014, last revision 01/19/2018