Planning a case for implant placement. #14 and #13 [maxillary left first molar and second premolar; 26, 25] are unrestorable. Resorbed ridge height is about 8mm at #14 area. My plan is to extract 13 and 14, place 11.5mm length implant for #13 (more apically for stability) and 6.0 diameter x 10mm length implant for #14. I plan to perform crestal approach lift, and lift approximately 3-4mm. My comfort zone would be to place a longer implant in 14 area but concerned about possible tear trying to lift too much, therefore planning to make diameter wider. My other concern is obtaining primary closure and risk of failure if I cant close suture once done, and risks of extracting, lift and implant placement all at the same time instead of extraction and grafting, waiting 4 months then implant placement with sinus lift. Ive attached CBCT, slices of 13 and 14 as well as intra oral of area. Your input is appreciated.
DR. JAINS COMMENT
Dr. Sam Jain says: October 25, 2014 at 10:53 pm
This is everyday bread and butter implant dentistry for my implant center. This case 100 percent immediate Exo, clean up, sinus lift through the socket, immediate implant and always screw retained temporary, no cuts, no stitches, and after 4 months impression with custom impression copings( made from the screw retained temporaries), funk rock cast,scan bodies, trios or D900 scanner, full contour screw reasoned zirconium crowns cemented to tibases ( all done in office milling Center) and unsurpassable cosmetics……10k. Case finished in 4 months and only one surgery with no cuts and no stitches, and Px leaves with no open wound.
Only few motrins next day.
Once u lift the gum from the bone, the god given archetecture gets wiped out right in front of your eyes.
To be a good implantologist, you gotta be restoring your cases. Knowing surgery only is not good enough. That’s the nature of the beast.
Since there are no cuts, there is no lateral approach.
Sam Jain, DMD
Center for Implant Dentistry
Fremont, CA
