Central Placement

A 54-year-old man has poor dentition, including missing tooth of #19 and residual root at #20 (Fig.1).  The lingual crest (Fig.2 (lingual view), Fig.4 (L)) is lower than the buccal one.  The Inferior Alveolar Canal (Fig.3 IAC) becomes the Incisive Canal (IC, Fig.4 red circle) after the Mental Loop (Foramen).  An implant at #21 will be placed at the level between the buccal and lingual crests (Fig.4) with osteotomy initiated in the middle of the socket.  Bone graft is to be placed around the coronal end of the implant (yellow circles).

The socket at #19 appears to have not completely ossified (Fig.1 *, Fig.5).  Use Magic Split and Magic Expanders to expand the ridge top so that an implant will be placed higher for favorable crown/implant ratio (reduce abutment screw loosening).  Note the concavity at the site of #19 while osteotomy (Fig.2 *).

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Xin Wei, DDS, PhD, MS 1st edition 01/20/2018, last revision 01/20/2018