Redo Implant Placement with Bone Expanders

Four and a half months post implant removal, the patient returns for #14 implant placement.  To increase bone density, bone expanders are used through the metal sleeve of the previous guide after use of 2.2x7.5 mm drill with 3 O-rings (1 mm shorter than previously designed; Fig.1).  The osteotomy continues to form by bone expanders until 2.4/3.7 mm, followed by a 4x10 mm dummy implant (Fig.2-4).  Finally a 4.5x7.3 mm implant is placed with ~ 25 Ncm with simultaneous sinus lift  (Fig.5).  There is no postop nasal hemorrhage.  The implant dislodges with the healing abutment 2 months postop.  The patient will return for follow up 3 months post 2nd loss.  We are going to try again with PRF, UF guided sinus lift kit, sinus expander kit.  After implant placement, use the implant at #13 and abutments at #13 and 14 to fabricate splinted provisional to hole the newly placed implant in place.  Take preop PA and possible CT.  In fact CT and impression are retaken for a new guide.

Return to Upper Molar Immediate Implant, Armaments, Trajectory II Xin Wei, DDS, PhD, MS 1st edition 02/12/2019, last revision 07/27/2019