2 mm 1-Piece Implant Fracture

The implant access at #9 closes 1 week post implant fracture (Fig.1,4).  There is mild gingival erythema at #10 (Fig.2,3 ^).   There is bone around the fractured implant, which is palatally placed (Fig.5).  The 2 mm implant is removed using 2/3 mm trephine bur.  In spite of moving the osteotomy buccally, a 4.5x4 mm, 15 degree A-type angled abutment is installed for an immediate provisional following placement of a 3.5x10 mm implant (Fig.7, 25 Ncm).  Sticky bone is placed (Fig.7 *) palatal to the implants at #9 and 10 (with thread exposure, Fig.6).  While the majority of periodontal dressing remains in place (Fig.9,10), the suture in the exposed area appears to hold the papilla in place (Fig.8 <).  Herpetic infection develops in the palate (Fig.9).  Two months later, the gingiva at #10 is healthy; it appears that the implant threads are covered by bone graft.  The immediate provisional (fabricated before suture) keeps the gingiva in an ideal position for impression of final restoration.  It appears that the access hole is in a right area for screw retained restoration.  The gingival cuff is healthy immediate pre-cementation, 4 months postop (Fig.12,13).  The lab does not make access hole for the final crown (Fig.14).  The implant remains subcrestal 4 months postop (Fig.15).  Since the shade of the crown is off, the abutment remains un-torqued and the crown is cemented with temp bond.  The implant threads at #10 seem to be covered by bone graft 4 months postop (Fig.16).

Return to Trajectory II No Deviation  1-Piece
Xin Wei, DDS, PhD, MS 1st edition 06/12/2020, last revision 12/26/2020