The wound is gapping over the implants (Fig.8) one week postop. The rough surface (*) of the implant at the sites of #26 and 27 is exposed; it is supposed to be covered by the bone (bone graft in this case).
There are two reasons for wound opening: tension and poor oral hygiene (this photo is taken after thorough scaling). There is severe tissue atrophy over the canine regions.
The splinted provisionals over #22-27 implants is immediately placed, although there is minimal occlusal contact. The patient is instructed not to chew with them. Considering the fact that the remaining teeth #28 and 29 are severely periodontally compromised, the provisionals should be regarded as immediate loading.
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Xin Wei, DDS, PhD, MS 1st edition 04/18/2013, last revision 04/18/2014