低扭力

左下7钻洞中出现三种情况：容易出血（血小板减低（9万）），疼痛（根尖肉芽肿）和骨质疏松，钻洞深度还没达到，使用短小报废植体拍摄根尖片（图一），之后下颌牙槽神经阻断，钻洞没有疼痛，但是未注意骨质疏松问题，按照正常钻洞顺序，所以正式植体扭力低，10 Ncm（图二），放置骨粉和不可吸收膜，PTFE缝合（图三）。术后一周膜舌侧稍微外翻（剪太小些，图四）。病人将术后五周回来去除膜，之后拍摄咬翼片证实骨粉丧失与否。其实病人提前回来，抱怨缝线不适，膜不翼而飞（图五，折线后），患侧咀嚼，因为对侧下颌第二磨牙疼痛又不肯拔除。The bone graft placed at the time of immediate implant (Fig.3 *) is apparently changing into the normal bone 4 months postop before uncover (Fig.6).  After removal of the bone coronal to the implant with a curette, a 4x4(3) mm pair abutment is placed (Fig.7).  Two weeks later the abutment screw is torqued at 20 Ncm.

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Xin Wei, DDS, PhD, MS 1st edition 11/13/2020, last revision 04/05/2021