Lindamann Bur I

A 67-year-old man with history of chronic periodontitis and bruxism returns to clinic requesting implant for the tooth #20 with mobility (Fig.1).  To assure No Deviation of implant placement, Lindamann bur will be used to remove the most coronal of the buccal aspect (Fig.2 *, 3 pink dashed line) of the thick lingual plate (L) during osteotomy.  To reduce bone loss (Fig.4 *) associated with residual cement (Fig.4,5 arrowheads) of the tissue-level implants, a bone-level one (SM) will be used at #20.  Check whether the nearby implant (#19) has infection clinically and bone graft if needed.  Buccolingual threads of the #27 implant are also exposed 3 years 9 months post cementation (Fig.6).  An ideal treatment is probably to remove the 4.5x17 mm tissue-level implant and place a 3.8x10 mm bone-level one deeper and a little mesial with bone graft.

Return to Lower Premolar Immediate Implant, Metronidazole Shield Waterlase
Xin Wei, DDS, PhD, MS 1st edition 12/24/2019, last revision 12/25/2019