Immediate Implant Redo with Sticky Bone and PRF

When the woman with periimplantitis at #30 returns to clinic, the abutment is found to be fractured (Fig.1 *) and difficult to remove.  After implant removal with trephine burs, osteotomy is initiated lingual (Fig.2).  A smaller and shorter implant (4.5x11.5 vs. 5.0x13 mm previously) is placed deeper (Fig.3) so that there is space for sticky bone buccal and coronal (Fig.4 *, 5 (postop reanalysis of preop CT)).  After placement of 2 pieces of PRF membranes, the wound is closed with 4/0 PGA.  The buccal flap is perforated due to periimplantitis and surgical manipulation.  Periodontal dressing is applied.

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Xin Wei, DDS, PhD, MS 1st edition 07/01/2020, last revision 07/01/2020