Bone Expansion and Bending (BEB)
A 71-year-old man requests restoration at #18-20 (Fig.1). Placing implants at the narrow ridge of the sites of #18 and 19 is quite challenging (Fig.3,4), as compared that at #31 (Fig.5). Since the bone density at the crest is high (1200-1500 u), use a surgical high speed fissure bur for sectioning the crest, followed by BEB at 11 mm. It appears safer to place 1-piece implant (Fig.3) than 2-piece one (Fig.4). Since the total mesiodistal distance for #18-20 is 18 mm, splinting the three-units should be a sound treatment option.
After removing the residual root at #20, no antibiotic will be used for socket disinfection except gauze. It seems that an implant smaller than 4 mm is needed (Fig.1,2).
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Lower Premolar Immediate
Implant, IBS
Xin Wei, DDS, PhD, MS 1st edition 08/24/2016, last revision 08/24/2016