Short and Stable
With one carpule of Xylocaine 34 mg with Epinephrine 17 mcg (infiltration) and slow osteotomy with guide, two short implants are placed at #29 and 30 painless with >45 Ncm (Fig.1). Healing abutments are placed without bony interference (Fig.2). It appears that the tooth #31 shifts mesially (Fig.2 arrow), which should be slowed down and/or corrected with early provisional. There is no bone loss 4.5 months postop (Fig.3). With placement of 4.5x4.5(3) and 5.2x4.5(4) mm abutments at #29 and 30, respectively, no limited orthodontic treatment seems to be needed. The screw at #29 becomes loose 4 months post cementation and a few days after #19 implant is loose (bruxism). In fact this is not completely true, since the abutment at #29 is incompletely seated (Fig.4). The abutment at #30 is also incompletely seated because of the vertical gap (<), probably due to mesial and distal crestal interference (*).
Return to Lower Arch Molar Premolar Immediate Implant, Trajectory 18-20 (Redo) Xin Wei, DDS, PhD, MS 1st edition 10/23/2018, last revision 08/15/2021