Lingual Abscess

A 53-year-old woman develops an abscess lingual to the tooth #20 before #19 final restoration.  Reanalysis of CT taken 5 months earlier shows the thin buccal plate (Fig.1 B).  A 3.5x13 mm bone-level/3.5x17 mm tissue-level implant should be lingually placed (Fig.2,3).  Socket shield will be performed (Fig.4 *); the lingual cortex removed with Lindamann bur (red) for ~1.6 mm.  Initial osteotomy will be conducted in the lingual wall of the socket coronally (Fig.5 white arrow); after penetration, the initial drill will change the trajectory (Fig.6).

Lower Premolar Immediate Implant, Trajectory II Clindamycin Metronidazole No Antibiotic #3 11

Xin Wei, DDS, PhD, MS 1st edition 12/07/2019, last revision 12/08/2019