Guide for Narrow Space

A 72-year-old man has lost #3 for a while with narrow mesiodistal space and is reluctant to have an implant because of his sinus problem.  It may be associated with failure of the teeth #18 and 19, requiring implants.

I have reviewed the patient's #3 position and as you have also indicated, interproximal distance is 5mm so regular metal sleeve won't fit in. So narrow metal sleeve with yellow color should be used. The best implant size would be 4.5 X 10.0mm but in order to use narrow sleeve with some offset, 3.5 X 10.0mm implant placement is suggested.

Thanks for nice analysis, Jennifer.  Has any of your doctors reported narrow implant fracture?  I have tried to use 3.0 mm 1-piece implants in molar area (narrow space) without ill effect.  For two-piece narrow implant e.g. 3.5 mm, the wall of the implant where the abutment is located must be thin and vulnerable to fracture.  If the patient agrees, I will try.

Hi Dr. Wei,
To be honest with you, most dentists do not place narrow implant at molar sites. And for this kind of special case having narrow space, I've seen other doctors placing at least 4.5mm diameter after removing the mesialized teeth and having enough space for the implant placement.
So, that's why I suggested 4.5mm diameter first on the screenshots. But for this case, due to narrow space only diameter that will work would be 3.5mm diameter. sizewise.
If you are worried about the fracture, then I do not recommend you to place 3.5mm diameter implant at molar site even the crown size would be a lot smaller than the molar due to narrow interproximal space.  Please let me know how you'd like to proceed.

If the patient agrees, I would like you to make a guide so that a 3.5x10 mm 1-piece implant will be placed.  Thanks.

Return to Upper Molar Immediate Implant, Armaments

Xin Wei, DDS, PhD, MS 1st edition 06/17/2018, last revision 06/18/2018