Implant Shorter Than Planned

The leukoplakia at the sites of #31 and 32 is most likely related to smoking and the supraerupted teeth #1 and 2 (Fig.0 ^).  After osteotomy for 11.5 mm at #31 (Fig.1), it appears that the bone height is not as much as expected.  The last two drills for sequential osteotomy are 4.3x13 and 4.8x11.5 mm.  A 5x11.5 mm UF implant is placed slightly subcrestal with insertion torque > 50 Ncm (Fig.2).  Following placement of 6.5x2 mm healing abutment, the opposing tooth needs adjustment for height.  Orthodontic intrusion of the opposing tooth is scheduled 2 days later.  It is accidental to find root fracture of the mesial root of the tooth #30 (Fig.1 <).  There is minimal bone resorption coronally 5 months postop (Fig.3).  A provisional is fabricated at #31 to assist in intrusion of the tooth #2.  A crown is cemented 11.5 months postop (Fig.4); the leukoplakia at #31 seems to lessen.  The tooth #30 is lost during the pandemic, followed by looseness of the crown and abutment at #31.  When the complex is reseated, the occlusal scheme is changed, suggesting incomplete seat of the abutment earlier (Fig.5).

Return to Lower Molar Immediate Implant, IBS 13  Xin Wei, DDS, PhD, MS 1st edition 03/14/2017, last revision 12/01/2020