His chief complaint is pain at #19 after eating popcorn.  The septal bone resorbes (Fig.2,3 *) with granulation tissue between the mesial and distal roots (Fig.4,5 *). Inferior Alveolar Canal (red dashed line) is indistinct apical to the tooth #19.  Although there is no bony wall defect, the socket is single and large.  The largest (8 mm) cylindrical implant should not be able to obtain primary stability.  The biggest challenge for immediate implant is ambiguous the Inferior Alveolar Canal (Fig.1,3 red dashed line).  If there were no financial or time issue for immediate implant, CBCT should have been taken.  Socket preservation is done instead with Vanilla graft, Human Amniotic Chorion membrane and Osteogen Plug (Fig.6).  If he returns for SRP and implant, perform flapless bone expansion for osteotomy.

No Immediate Implant Last Next

Xin Wei, DDS, PhD, MS 1st edition 05/11/2018, last revision 07/16/2019