Parallel to 1st Molar

A 60-year-old man has chronic periodontitis, bruxism and malocclusion, e.g., #18 mesiolingual inclination (under occlusal trauma, Fig.1).  The lingual pocket is deep with severe bone loss.  After extraction, use implant positioner to gauze the size of the socket.  Initiate osteotomy as mesial as possible and parallel to the 1st molar (Fig.2,3).  Bone density is expected to be high.  Prepare soft (1-piece) and hard (IS) tissue-level implants.  The tooth remains loose 2 years later, although the patient is asymptomatic (Fig.4).  Finally the tooth is symptomatic because of root tip fracture (Fig.5).  Use drills with 7.3 mm stop for 4.5 or 5.0x8.5 mm implant free hand (Fig.6).  The exposed implant will be covered with sticky bone (PRFx2).  Prepare temporary and cemented abutments to hold bone graft in place.

Return to Lower Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Armaments, No Deviation No Antibiotic 13, 18, 4 Xin Wei, DDS, PhD, MS 1st edition 12/24/2017, last revision 06/16/2020