Short or Long Implant?

A 67-year-old woman fractures the tooth #29 three months post RCT.  There is persistent periapical radio-lucency (Fig.1 yellow dashed line), which is close to the Mental Loop (red dashed line).  Since the root of the affected tooth deviates distal, osteotomy will be established mesial (Fig.2).  To reduce the chance to injury the buccally located loop, the osteotomy should be as lingual as possible.  Initial depth will be 15 mm (shy of the Loop, bone level, 18-19 mm gingival level) with 2 mm drill, followed by the marked parallel pin.  If primary stability cannot be achieved, place a long implant as indicated in Fig.2 as long as the osteotomy remains lingual.

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Xin Wei, DDS, PhD, MS 1st edition 07/25/2017, last revision 08/08/2017