Soft, Long Bone

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