Implant in Short Mandible

A 51-year-old lady had the crown at #18 cut off because of open margin in the other office lately.  The margin was found and confirmed too subgingival to be restored.  Three years ago, the tooth #31 was extracted and replaced by an immediate implant (7x11 mm (trajectory off, light blue, Fig.1 (CT 3 D image)).  The implant is close to the Inferior Alveolar Canal (orange) and the Submandibular Fossa (SF).

CT sagittal (Fig.2) and coronal (Fig.3 (mesial root), 4 (septum), 5 (distal root)) sections show that a 6x11 mm tissue-level implant is to be placed.  The smaller implant may produce less buccal implant exposure.  After extraction and socket (mesial and distal, Fig.2) treatment with 2% Xylocaine/1:50,000 Epinephrine gauze, Tatum posterior osteotomes (BS, BB) may be used to section the septum before inserting 4.5, 5 and 6 mm taps.  The Bicon 2 mm drill and reamers may be used.  The depth is tightly controlled at 11 mm.  The implant is to be placed in the mesial socket.  The implant platform will be more or less be parallel to the crest (easy for restoration, mastication force parallel to the long axis of the implant crown, mesiodistally).

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Xin Wei, DDS, PhD, MS 1st edition 10/18/2015, last revision 10/30/2015