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A 32-year-old woman develops periimplantitis (severe hemorrhage and deep pockets) at #14 three years 7 months post cementation (Fig.1). A 4.5x11 mm implant is placed with flap at #13 after failure for the 1st time (Fig.2), while a 5x11 mm implant is placed flapless with sinus membrane perforation. Uniposts are cemented with Ketac. The lingual (L) plate at #14 is defective (Fig.2,3). The implant at #14 will be removed flapless, followed by Osteogen plug (most likely sinus floor defect) and bone graft. After healing, an implant will be placed with guide.
Xin Wei, DDS, PhD, MS 1st edition 12/01/2018, last revision 02/22/2019