When Vertical Space is Not Enough M

Before incision, the vertical space for the site of #18 is measured (~5 mm).  In addition, the tooth #15 is in buccoversion with the pointed mesiolingual cusp.  The initial depth is 11 mm after ridge reduction (Fig.1).  After Magic Drill 4.8 mm for 11 mm, a 5x9 mm dummy implant is placed incompletely with stability (Fig.2); there is an apical space (^).  Because of limited vertical space for restoration, the final implant remains shorter than the osteotomy (5x9 mm), but it is placed deeper (Fig.3); a definitive abutment is placed immediately (6x4(3) mm).  After adjustment of the opposing tooth (mesiolingual cusp) and the abutment (restoration space having been established), periodontal dressing is applied.  There is minimal bone loss 4.5 months postop (Fig.4,5).  Without preop CT and guide, the implant perforates the lingual plate (Fig.7,8 >).

Return to Lower Molar Immediate Implant, IBS, #4  19 下齿槽神经 Xin Wei, DDS, PhD, MS 1st edition 10/26/2017, last revision 08/04/2021