Hard Bone  Armaments

The bone at #30 and 31 is so hard that plenty of bone shaving is saved as bone graft to be placed in the socket of #31 post implantation (Fig.1,2 * (blue dashed line: #31 socket)).  The guide is long and stable, allowing osteotomy without use of an anchor pin.  Since the vertical space is limited, no provisional is fabricated.  The bone graft is kept in place with collagen plug on the top and suturing.  No provisional is fabricated because of limited vertical space (Fig.2).  It appears necessary to intrude #2 and 3, which seems difficult since the patient is a bruxer (hard bone). The implants are placed as planned because of metal tubes (Fig.3).  The patient develops postop pain, which is relieved by taking 800-1000 mg Ibuprofen every night.  Exam shows mild percussion at the tooth #29 with gutta percha extrusion and periapical radiolucency (Fig.1,3).  An endodontist refuses #29 RCT retreatment.  What should be done?

Return to Lower Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Armaments, 2nd Immediate with Guide  Application

Xin Wei, DDS, PhD, MS 1st edition 08/24/2018, last revision 01/31/2021