Implant in Narrow M-D Space

A 42-year-old lady lost the tooth #30 at the age of 16-17.  The mesiodistal space is narrow.  It appears that a 3 mm 1-piece implant is appropriate (Fig.1).  If the buccolingual width is reasonable and the keratinized gingiva is wide, use 3 mm tissue punch for access.

In fact the keratinized gingiva is not wide.  An incision is made for access.  The buccolingual width is ~ 6 mm.  A 1.2 mm pilot drill is used for initial osteotomy at the depth of 12 mm (Fig.2 (red dashed line: the superior border of the Inferior Alveolar Canal)).  Enamel-plasty (arrowheads) have been done to increase M-D space.  A 3x14 mm bone-level implant is placed with insertion torque of ~ 30 Ncm (Fig.3).  After further distal enamel-plasty, an immediate provisional is delivered.

There is no bone resorption 4 months postop (Fig.4).  Bone density around the implant increases 8 months post cementation (Fig.5).  The gingiva is healthy nearly 10 months post cementation (Fig.6).

Return to Lower Molar Immediate Implant Implant & Ortho 2 1-Piece 6 mm 1-Piece

Xin Wei, DDS, PhD, MS 1st edition 11/16/2015, last revision 07/23/2017