Extra Wide Implant

The 61-year-old man is nervous about dentistry.  When he returns for #4 implant, he wants an implant at #31 first.  Fig.1 shows #31 crown fracture after root canal therapy.  Three years after crown placement, there is sign of mesial root fracture (Fig.2 arrowheads).  Four years post extraction, bone height is 12 mm (Fig.3 parallel pin 10 mm).  An extra wide implant is to be placed, since there is enough bone width.  With infiltration anesthesia, the patient feels pain when a 5.4x10 mm drill is being used, 1 mm short of the desirable depth (Fig.4).  After Inferior Alveolar Nerve block, the last drill reaches the depth.  A 5.9x10 mm implant is placed with insertion torque 50 Ncm (Fig.5 I).  A 7.8x4(3) mm cemented abutment (A) is placed immediately.  After suturing, the restorative portion of the abutment is covered by the gingiva.  It is probably due to over tightening the sutures.  It would be ideal to adjust the gingival level before tightening the second suture.

The implant appears to have osteointegrated 8 months postop (Fig.6).  The bone loss is minimal 1 year 3 months post cementation (Fig.7) and 1 year 10 months post cementation (Fig.8).

Return to Lower Molar Immediate Implant 5 Xin Wei, DDS, PhD, MS 1st edition 04/15/2016, last revision 02/09/2019