Redo: Shorter Implant Placed Deeper with Better Surface Treatment

When an IBS implant with PAT surface (4.5x9 mm at #14; Fig.1 CT coronal section with ~ 7 mm bone height) is uncovered nearly 12 months postop, it is loose with a peri-implant space.  Immediately post its removal and debridement, an IS dummy implant with SLA surface treatment (Fig.2: 4.5x10 mm) is placed.  When a definitive implant is placed (Fig.3,4: 5x7.3 mm), it is subcrestal buccally and nearly equicrestal palatal.  The remaining periimplant space is to be filled with demineralized cortical allograft.  PAT: photo activated treatment (particles of calcium phosphate and a heating treatment).  There is no apparent bone loss 3 months postop (Fig.5,6).  The implant is uncovered with placement of a 5.7x4(4) mm cementation abutment and a nonfunctional provisional.

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Xin Wei, DDS, PhD, MS 1st edition 07/17/2018, last revision 10/23/2018