Free Hand Immediate Implant or Socket Preservation (I)

A 51-year-old woman has poor dentition with chronic periodontitis (Fig.1).  She has financial constraint, but refuses RPD, insisting upon UR posterior implants first.  After discussion of severe bone loss, she agrees with bone graft first (Fig.2-4).  Since the bone atrophy is the most severe at #3 (Fig.5 coronal section; L: lingual), sinus lift (Fig.6 arrow) is conducted after extraction (black).  Use sticky bone (Fig.7 red circles) and Titanium-reinforced Cytoplast (white) for socket preservation.  Or if Magicore is able to achieve primary stability (Fig.8 green), an abutment (pink) will be placed for an immediate provisional (white).  The latter are capable of holding bone graft in place.  Since bone loss at #2 and 4 is less severe (Fig.9 sagittal section), their roots will act as walls to keep bone graft (Fig.11) in place after #3 extraction (Fig.10).

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Xin Wei, DDS, PhD, MS 1st edition 12/02/2019, last revision 12/22/2019