Place A Shorter Implant 

Six months post implant removal and bone graft, the patient returns for #29 implant placement with guide.  With Lidocaine and Septocaine each carpule (infiltration), the patient experiences pain when the last drill used is ~ 2 mm short of designed depth.  To make sure to have lingual subcrestal placement and avoid the Mental Loop, a 3.5x8.5 mm implant is placed (Fig.1,2 (3 mm shorter than the design)). Immediately postop CBCT (sagittal section) shows that the osteotomy probably hits the branch from the Mental Nerve (Fig.3 <).  The coronal portion of the implant is covered with apparently grafted bone (Fig.4 <; bone density ~ 1,000 Hounsfield units; L: lingual).  The implant will be loaded longer than 4 months due to unfavorable crown/implant ratio.

Return to Lower Premolar Immediate Implant, Trajectory
Xin Wei, DDS, PhD, MS 1st edition 02/14/2019, last revision 02/16/2019