Immediate Replacement of Periimplantitis

A 64-year-old woman has had sign of periimplantitis at #29 (Fig.1 (CBCT sagittatl section)) in the last 3 years.  It appears that the implant is buccally and superficially placed (Fig.3 (coronal section)).  Although RCT at #28 is incomplete (Fig.2), there is no symptom or sign of active infection; no treatment will be rendered. 

Immediately post implant removal at #29, a 3x10(4) mm 1-piece implant will be placed as lingual as possible (Fig.3).  In fact the apical portion of the implant will be lingual to the Mental Loop (Fig.3 orange).

Since the implant at #29 is narrow, an implant at #30 seems necessary (Fig.4).  Trim the ridge top for approximately 3 mm until the ridge is about 5.8 mm for a 3.8 mm implant.  Control of the depth needs to be precise.

The mesial (Fig.1 >) and lingual (Fig.5 <) threads of the implant at #31 appear to be further bone graft to prevent periimplantitis.

Request information of the existing implants and buy implant driver.  Ask the treating dentist whether the bridge is temporarily cemented.  Take Alginate impression for surgical stent.

Return to Lower Premolar, Molar Immediate Implant, IBS, UL

Xin Wei, DDS, PhD, MS 1st edition 04/17/2017, last revision 01/19/2018