In spite of a shorter implant (3.8x13 mm) placed deeper, approximately 7 mm implant threads are not covered buccally by the native bone (Fig.6 red dashed line).  If the implant were placed deeper, the crown/implant ratio would become more unfavorable (abutment screw loosening, Fig.7).  Since a mill abutment (4.5(2) mm) is inserted before Vanilla Graft, the deepest portion of the socket is unfilled (Fig.7 *).  With meticulous use of a long explorer and additional allograft, the space is closed (Fig.8 *).  Bone remains around the implant 6 months postop (Fig.9), but the tooth #13 has shifted mesial.  The tooth #13 is distalized using #14,15 implants as anchors nearly 2 months (Fig.15).

Deep Placement Last Next

Xin Wei, DDS, PhD, MS 1st edition 03/08/2019, last revision 03/08/2019