When a 2x16 mm parallel pin is inserted at #13 after extraction, PA does not show the upper end, as related to the long bone (Fig.1). In spite of underprep osteotomy, a 3.8x18 mm implant achieves ~ 20 Ncm of insertion torque (Fig.2). The long implant is still in the lower half of the triangular (cone-shaped) bone (Fig.3 red dashed line) between the nasal cavity (N) and the maxillary sinus (S). The bone is also wide. When a 4.5x5(5) mm abutment is placed, it is buccal. It appears that an angled abutment is needed for final restoration (probably 4.5x15 or 25 degrees, 5 mm cuff). When an angled abutment is placed 1 month posotp, the implant is found unstable. A healing abutment is placed (5.5x7 mm). Progressive loading is initiated 4-5 months postop. The implant becomes stable nearly 5 months postop (Fig.4), but the buccal gingiva is erythematous and tender, probably due to infected bone graft (one large piece), which is removed. One week later, the gingiva looks normal; impression is taken (Fig.5).
Return to Upper Premolar Immediate Implant, Armaments Xin Wei, DDS, PhD, MS 1st edition 07/09/2018, last revision 12/18/2018