The implant is removed after several carpules of cocktail anesthetics for infiltration and one carpule for block.  Osteotomy is initiated in the mesial slope of the defect (Fig.2,4).  The advantage of immediate implant re-placement is wide bone at the intended area (Fig.3). After change in trajectory (compare Fig.4 (4x11 mm dummy implant) and Fig.5), a 4.5x9 mm IBS implant is placed with insertion torque of 50 Ncm (Fig.5); with Osteogen plug placed in the distal defect, allograft (*) is placed immediately distal to the implant.  With the longest cuff available (4 mm), the margin of the abutment (4.5x4(4) mm) is equi-crestal (>).  When the 9 mm long implant is placed deep, the coronal threads of the implant are distally exposed (Fig.6 between arrowheads) less than those of the 11 mm one placed superficial (Fig.2).  Intraoperative socket hemorrhage is controlled by packing gauze saturated with Epinephrine 1:50,000.

Long-Cuffed Abutment Last Next

Xin Wei, DDS, PhD, MS 1st edition 06/19/2017, last revision 10/01/2017