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Fig.3: Implant placement at #19 with guide. The gingiva around the healing abutment (5.5x3 mm) at #19 is erythematous (Fig.5), probably related to the submerged abutment. There is no bone loss 5 months postop (Fig.6) or 7.5 months postop (Fig.8). The abutment screw is loose 3 months post cementation due to unfavorable crown/implant ratio (Fig.10). Bicon implants will be in consideration to reduce screw loosening if implants are to be placed at #15 and 18. In fact the abutment is incompletely seated. The crown at #19 is loose again 1 year 5 months post retightening. After removing crown/abutment, the mesial surface of the crown is heavily reduced. The crown/abutment is reseated to make sure that there is no proximal contact between the neighboring teeth (Fig.14 arrow). Because of tilt of the PA, it is difficult to tell the tightness of the contact between the implant and abutment (5.7x5.5(3) mm), but the apical space is significantly reduced (*, as compared to Fig.10). Pick up impression is taken for porcelain addition occlusomesially.
Xin Wei, DDS, PhD, MS 1st edition 01/16/2021, last revision 03/16/2021