Socket Shield in Narrow Space

The edentulous area at #7 is narrow both buccopalatally and mesiodistally, whereas the crowns of the neighboring teeth are long (Fig.1,2).  For the latter reason, it is difficult to remove the apical portion of the root, including gutta percha with surgical handpiece (Fig.3 *) for socket shield (Fig.2 *).  To avoid the perspective implant touching socket shield, initial osteotomy is palatal.  When a 2 mm drill is being used, the coronal end of the palatal plate starts to perforate.  A 2.5x14 mm 1-piece implant is placed with 30 Ncm (Fig.4).  The palatal plate is thin (Fig.5).  Preop CT will help determine the position of initial osteotomy.

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Xin Wei, DDS, PhD, MS 1st edition 10/18/2018, last revision 10/18/2018