A 5x9 mm implant is placed with packing abundant allograft (.5-1.5 mm) and Osteogen; it appears that 3 to 4 threads (fins) of the implant are engaged to the native bone for primary stability (>40 Ncm).  Later more bone graft is placed distally (Fig.5 arrow).  Abutment: 6.5x5.5(4) mm. The patient in fact masticates on the right side postop.  By the time he returns for provisional revision 1 months 10 days postop, he has mild pain.  There is food entrapment.  The provisional and the abutment are slightly loose, whereas the implant is stable with healing socket.  A healing abutment (6x4 mm) is placed.  The implant appears unstable nearly 5.5 months postop.  The gap between the bone and implant seems to be large (Fig.9).  The implant should have been larger and longer for fast healing.  A healing screw is used instead.  The site heals 10 months postop with an increase in bone density around the implant (Fig.10).  In fact the abutment screw becomes loose 2 months post cementation (1 year postop); it appears that crown/implant ratio is unfavorable (Fig.12).  The implant is slightly placed distally (cantilever).  The tooth #18 is missing (unilateral mastication). 

9 mm Implant Last Next

 Xin Wei, DDS, PhD, MS 1st edition 10/04/2016, last revision 03/03/2019