Mental Loop M

Osteotomy starts in the lingual slope of the socket of #29 with Point/Lindamann bur, but a little too distal.  Gradually the osteotomy is moved mesial; the trajectory and position (Fig.1) are better than designed, but the osteotomy is close to the Mental Loop (red dashed line).  When a 4x11.5 mm implant is placed, it appears to overlap the buccally positioned Loop (Fig.2 red dashed line).  In fact there is no postop paresthesia.  The implant placement level seems to be ideal (Fig.3 after bone graft).  There is foul smell from the immediate provisional; in fact it may be due to the loose contact between the implant and abutment (Fig.4 < (4 months postop)).  The gingiva is unhealthy.  A 5.5x5 mm healing abutment is placed.  When the patient returns 5 months postop, the gingiva is healthy after removal of the healing abutment.  A 4.5x4(4) mm cemented abutment is seated without interference and torqued to 35 Ncm (Fig.5).

Return to Lower Premolar Immediate Implant   Trajectory II    No Deviation Prevention
Xin Wei, DDS, PhD, MS 1st edition 08/04/2019, last revision 05/07/2020