SRP M

A 40-year-old man (smoker, 1ppd) is concerned about #31 mobility (Fig.1).  Gross debridement is finished in his 1st appointment, while impression is taken for guide in his 2nd one. SRP has been scheduled for lower right quadrant with #31 extraction and immediate implant (Fig.2).  The tooth #17 extraction will be postponed.  The extraction may lead to mobility of the tooth #18, although SRP for the other 3 quadrant will be scheduled 1 week post #31 surgery.  Smoke reduction is encouraged.  When the crown is delivered at #31 one year later, the tooth #18 is loose (Fig.3) with lingual fistula.  Since bone loss is more severe lingual (L *), a 5x10 mm immediate implant will be placed buccal (Fig.4).  The tooth #17 will be kept as a distal stop for guide and extracted after #18 implant placement.  Bone loss at #18 is more severe with mobility 15 months later; a shorter implant will be placed (Fig.5).  After local scaling & root planing of the distal surface of #19 and application of Endogain, place sticky bone (red circle).  Insert Collagen or Osteogen Plug in the #17 sockets.

Return to Lower Molar Immediate Implant, Trajectory II  Surgery 31 18  第二磨牙即种 Xin Wei, DDS, PhD, MS 1st edition 07/26/2019, last revision 04/18/2021