Limited Vertical Height

A 46-year-old woman returns for preparation for an implant at #30 two years 3 months post #6 (M) and 7 implant crown cementation (Fig.1).  With the moderate ridge, implant placement should be easy, but the vertical restorative height is limited due to the opposing supraerupted molar.  If the keratinized gingiva is narrow, make incision instead of tissue punch.  In fact the crestal cortex is the most important structure associated with implant placement and should be carefully studied prior to implant design (Fig.2 arrowheads in 3D view as well as the sagittal and coronal (Fig.3) sections).  If socket preservation were done, the ridge would be wider and taller (Fig.4 yellow dashed line) with possible thicker cortical bone.

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Xin Wei, DDS, PhD, MS 1st edition 03/04/2020, last revision 05/28/2020