Acrylic Dressing I

Immediate placement at #12 is smooth with 20 Ncm, whereas delayed one at #14 involves sinus membrane perforation; after insertion of PRF and mixture of autogenous bone and allograft, a shorter dummy implant tries in with stability (Fig.1).  The final implant at #14A07m.htm has ~60 Ncm, but the coronal palatal bone may be insufficient (Fig.2).  Sticky bone is placed to bury the implant at #14 (Fig.3 *).  After placement (incomplete, Fig.3 <) of a 4.5x7.5(4) mm pair abutment, setting acrylic is applied around the abutment, over the bone graft at #14 (to prevent loss) and pressed into the undercuts of the proximal surfaces of the neighboring teeth for retention (Fig.4).  The sockets at #12 heals 8 days postop when a 2nd acrylic dressing dislodges (Fig.5).  It appears that the retention of 3-unit acrylic dressing is poor.  The wound at #14 also heals, but it would be better to make an incision to save the soft tissue (Fig.6).  The bone/implant gap reduces at #13 five months postop (Fig.7 (complete abutment seating)).  There is no implant thread exposure at #13 (immediate), while minor exposure mesial to #15 (delayed).

Upper Molar Immediate Implant     No Deviation     Next Case
Xin Wei, DDS, PhD, MS 1st edition 01/21/2020, last revision 06/30/2020