Use Stable Implant to Hold Periodontal Dressing

Osteotomy at the sites of #30 and 31 is initiated with Magic Split, followed by Magic Expanders (3.0 and 3.8 mm) at #31.  Initial depth of osteotomy is 13 mm with 2.2 mm drill (Fig.1).  After adjustment of the trajectory at #31 (Fig.1 arrow) and deepening the osteotomy by 2 mm, dummy implants are placed with stability (Fig.2).  Following increase in osteotomy at #31, the larger implant in fact loses stability (Fig.3).  The loose implant is pushed distal (Fig.4 arrow) with placement of autogenous bone mesial (*).  The stable implant at #30 (Fig.3) and its abutment (Fig.4) are used as a post to hold periodontal dressing, which covers the wound at #31 after placement of collagen plug and suturing.  In fact the same technique could be used when socket preservation was performed if an implant were placed at #30 at the same time.  When the periodontal dressing dislodges, the wound at #31 heals uneventfully (Fig.5,6).  The bone graft seems to remain in place 3 months postop (Fig.7).  The implant is uncovered with placement of a 6.8x7 mm healing abutment 4 months postop.  When a cementation abutment is placed and prepped, the buccal margin is much lower than the lingual (Fig.8 taken prior to cementation).  The patient enjoys mastication with the new implant crowns 3.5 months post cementation (Fig.9).

Return to Lower Molar Immediate Implant, Armaments Xin Wei, DDS, PhD, MS 1st edition 12/13/2017, last revision 08/29/2018