There is bone loss distal to the 5x10 mm implant immediately placed (Fig.2 upper *).  Since the bone density is high, it is hard to place the implant to the lowest space (lower *, ~ 60 Ncm).  For compensation, bone graft (Fig.3 * ("sticky")) is packed securely around the implant before and after abutment insertion.   The incompletely seated abutment should be associated with foul smell when it is removed.  In fact the patient returns11 months postop (the 1st time postop), partly due to coronavirus.  The immediate provisional is lost, but the distal defect has apparently been repaired (Fig.4*).  A 4 mm cuff abutment is changed to due to enough occlusal clearance.  The abutment is completely seated.  Oral hygiene is poor with 1/2 ppd of smoke.  SRP was done in the lower right quadrant when the implant was placed.

Slow Gentle Osteotomy    Last    Next

Xin Wei, DDS, PhD, MS 1st edition 06/30/2020, last revision 06/30/2020