Full Guide/Sticky Bone

Nearly 4 months post implant exfoliation, the ridge at #14 looks narrow.  Incision reveals loss of the palatal plate coronally.  The same guide is used to finish osteotomy with modification.  There are several points of difference.  The 1st one is use of the guide for the complete procedure, including the implant placement so that there would be no apparent trajectory deviation.  A bone-level implant is used instead of a tissue-level one.  When a 4x11 mm dummy implant is ~1.5 mm shy of the depth (Fig.1 D), the palatal threads are exposed.  To reduce further exposure, the final/definitive implant remains 4.0 mm in diameter instead of 4.5 mm as designed, followed by sticky bone, particularly palatal (Fig.2,3 *).  In fact the implant is placed deeper than the failed one, relative to the sinus floor (Fig.4 (sinus lift without bone graft)).  In fact the implant is placed deeper (Fig.4 (4x11 mm bone-level) than the failed one (Fig.5 (same magnification; 4.5x14 mm tissue-level)), relative to the sinus floor (yellow line).

Return to Trajectory II No Deviation
Xin Wei, DDS, PhD, MS 1st edition 05/18/2020, last revision 05/19/2020