Palatal Socket Shield
With modification of drill sequence in the last 3 steps (4.5x7.3, 4.0x8.5 and 3.5x10 mm drills) at #14 and sinus lift (Fig.1), a 5x9 mm implant is placed with ~ 50 Ncm following back up twice. Sticky bone mixed with autogenous bone (Fig.1,2 white *) is placed in the sockets before and after placement of a 6.5x5.7(2) mm abutment. Since the palatal gingival margin is recessive (Fig.3 ^), a palatal socket shield retains to prevent further recession (Fig.4 in the end of periodontal probe). Because the margin of the abutment is low, it changes to one with longer cuff (Fig.5). An immediate provisional is fabricated (Fig.6,7 P). The bone graft is indistinguishable from the original alveolus 9 months postop (Fig.8 *). The palatal socket shield is exposed 10 months postop (Fig.9 <). Since the implant is intentionally placed buccal; the sheath is not essential.
Molar Immediate Implant,
Prevent Molar Periimplantitis (Protocols,
Xin Wei, DDS, PhD, MS 1st edition 10/18/2019, last revision 08/11/2020