Guided or Not

A 62-year-old man with more than 10-year-old lower RPD requests implant at #15 with history of tooth fracture (Fig.1).  Guided surgery is planned at #15 (Fig.2). 

The patient would like to have implants to replace the lower RPD if the 1st surgery turns out to be successful.  Due to the presence of the Mental Loop (Fig.1 red dashed line) and thin bone at #29 and 30 (Fig.3,4), 1-piece implants seem to be a good option.  A 2-piece implant can be placed at #19 (Fig.5).  After cementation of #15 implant crown, reanalysis of CT reveals that a 3x12 mm 1-piece implant is more appropriate at #19 with a space less than a premolar (Fig.6).  With 2 of narrow short implants at #29 and 30, violation of the Mental Loop is less likely to happen than a single one in the middle of the edentulous area (Fig.7).

Return to Upper Molar Immediate Implant, Armaments, Trajectory Xin Wei, DDS, PhD, MS 1st edition 04/0942018, last revision 11/17/2018