Osteotomy in Healed Site
A 68-year-old man had the tooth #19 extracted more than 6 months ago (Fig.1). When his wife has had an immediate implant placed, he decides to have his implant placed. After incision, use the 5 mm implant positioner to check the width of the crestal bone. If it is less than 6 mm, the implant length will be most likely 14 mm. Clinical exam has revealed moderate ridge atrophy. Anyway, the initial osteotomy is 12 mm. It should pass the apices of the mesial (M) and distal (D) sockets (Fig.2 ^) in the middle of the septum (as compared to Fig.1 S). If there is enough safety margin, the osteotomy depth will be set at 14 mm (Fig.3 (red dashed line: the superior border of the Inferior Alveolar Canal)). There is no indication for intraop localized use of antibiotic.
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Xin Wei, DDS, PhD, MS 1st edition 08/23/2015, last revision 08/31/2015