Short, Stable and Safe Immediate Implant
A 61-year-old man has repeated periodontal infection involving the furca of the tooth #30 (Fig.1) and agrees to have it extracted. Upon tooth removal, a soft tissue band is found to cross the furca (Fig.2 *). It is going to be detached lingually (Fig.2 >) and separated buccally to expose the septum (Fig.3 *). A 6x14 mm tissue-level implant is planned to be placed in the septum (Fig.4). Sequential osteotomy is finished in the septum with insertion of a 5x17 mm tap at the depth of 14 mm of the gingival margin level (Fig.5 T). Then a 6x14 mm implant is placed with insertion torque > 56 Ncm (Fig.6 I). Due to misplacement of the sensor, the Inferior Alveolar Canal (IAC) is not shown (Fig.5,6). With short implant design (Fig.4), there is minimal panic when the intraop PAs do not show IAC. After placement of an abutment (Fig.7,8 A) and bone graft (G) and change of a sensor holder, the implant is shown to have enough clearance from IAC (Fig.7 dotted line). The furca tissue band is transferred to cover the mesial socket, helping hold the bone graft in place (Fig.8 *). An immediate provisional is seated for further socket opening closure (Fig.9), but there is a small gap left (<). The final socket "seal" mechanism is placement of periodontal dressing (Fig.10 D). Postop pain and hemorrhage is minimal.
Return to Lower Molar Immediate Implant,
Posterior Immediate Provisional,
Xin Wei, DDS, PhD, MS 1st edition 07/17/2015, last revision 10/01/2018