Two of 2.5 mm 1-Piece Implants I

The edentulous ridge at #30 is narrow (Fig.1).  After ridge reduction, osteotomy is initiated with 1.2 mm drill for 10 mm; the mesial osteotomy is to be changed (Fig.2 red line).  Using a 1.2 mm drill placed in the distal osteotomy (Fig.3 D), the mesial osteotomy changes in trajectory with subsequent placement of a 2.5x10(4) mm 1-piece implant.  Since the mesial implant is high in occlusion, the cuff of the distal implant is changed to be 2 mm (Fig.4 (shorter black line)).  Panoramic X-ray is taken to show no violation of the Inferior Alveolar Canal (Fig.5 red dashed line).  These two 1-piece implants are slightly lingually placed (Fig.6).  The crestal bone around the implants resorbs without thread exposure 5 months postop (Fig.7).  Impression is taken for a splinted crown (Fig.8-12).  There is no metal show around the 2.5 mm 1-piece implants 6 months postop (advantage) vs. that at #28 and 29 (Fig.13).  Bitewing is taken post cementation to determine whether residual cement is present (Fig.14).  There is periodic swelling and pain in the lower right quadrant 2 years post cementation (Fig.15).  In fact periimplantitis appears to have developed at #28 (Fig.16) with loss of the buccal bone (Fig.17,18).  The buccal bone loss is less at #29 (Fig.19) and #20 (Fig.23) and no at #30 mesial and distal implants (Fig.20,21).  A much smaller implant will be placed lingually at #28 immediate (Fig.24,25).

Return to Lower Molar Immediate Implant, IBS, 20, 28/29

Xin Wei, DDS, PhD, MS 1st edition 10/05/2017, last revision 05/30/2020