Establish Initial Osteotomy with Correct Trajectory
A 48-year-old man has pain 4.5 months post apicoectomy at #29 and requests extraction and immediate implant. Since the mesiodistal bone width is limited, the 1st option is to place a narrow IBS implant (Fig.1). First at all, use 1.6 mm drill to establish osteotomy with correct trajectory. If the effort to change the trajectory and position fails, switch to a 3x14 or 16 1-piece implant to reduce the chance of abutment screw loosening. If intraop PA shows the mesiodistal bone width is not so narrow and stability is not ideal, use a UF implant (Fig.2). CBCT coronal section shows a 15 mm long implant may perforate the lingual plate (Fig.3 L). To place an implant lingually, the coronal end of the lingual plate should be removed (*).
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Premolar Immediate Implant,
Trajectory,
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6th Meeting
Xin Wei, DDS, PhD, MS 1st edition 09/07/2018, last revision 09/13/2018