Narrow Space and Narrow Ridge at #29

A 41-year-old slender woman returns for #29 and 30 implants (Fig.1,2) because of a fistula mesiolingual of #30 (Fig.3 arrowhead) several years post RCT.  There is no deep pocket at #30.  In fact the distolingual canal is missing (Fig.2 (black arrow),3 (DL)).  RCT retreatment should solve apical periodontitis.  Due to long term of missing #19 and 29, the mesiodistal space is limited with diastema between #28 and 29 (Fig.1, 2 (white arrowhead)).  Limited ortho appears necessary prior to, during or post implantation.  The ridge at #19 and 29 is not only narrow, but also short.  It seems appropriate to place short 2- and 1-piece implants, respectively (Fig.5,4).  As a matter of fact, there is open margin of the crown at #30 (data not shown).  If the crown is to be removed prior to RCT, implantation is conducted before ortho, since the provisional can be made narrow mesiodistally.

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Xin Wei, DDS, PhD, MS 1st edition 06/09/2018, last revision 01/25/2019