A 69-year-old man has poor dentition. The tooth #18 is missing, while the tooth #19 has large DO amalgam with overhang. Although there is apparent periapical radiolucency associated with the distal root, the tooth has no percussion pain.
After local anesthesia, amalgam overhang (*) in the distal cervical area of the #19 is examined. If it is subgingival, a small incision is made to expose and trim it (Fig.2 red line). If it is easily removed without incision, a 4 mm tissue punch is used for #18 osteotomy. For safety, a submerged implant system will be chosen for this case, since the surgical kit has drill stoppers. The first intraop PA will be taken following 2 mm pilot drill at 8-10 mm deep. A 5.3x12 mm implant is expected (Fig.2)
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Xin Wei, DDS, PhD, MS 1st edition 01/06/2015, last revision 03/14/2015