Anon. asks:
I have to place a dental implant in the anterior mandibular region to replace a lower central incisor which is congenitally missing. However, the neighbouring lateral incisors have been orthodontically treated and tilted in the mesiodistal plane to make room for central incisors, with the result that their apices have come very close to each other. Now when I place the implant, there is a possibility of contacting the apex of the lateral incisors. This may lead to endodontic treatment of the lateral incisors. My question is, what are the chances of failure of the implant if it comes in contact with the apices of the lateral incisors?
If you have enough height (10mm, 13mm) you should not have any issues with damaging the apices. If not enough room, have the adjacent teth orthodontically uprighted to that the roots are parallel. It will increase treatment time but it will ensure proper placements without complications.
go ith an endopore implant, 3.3 x9mm, hat should do it,if you have less than that height i would say that you are in trouble.
best of luck
if you are worried, get a scan, get a surgical guide done and you should be fine if the space is there. DO NOT !!! do the surgery if you know there will be a complication, GET A SCAN WHEN IN DOUBT!!! will make your life so much easier!
Do not place an implant if the adjacent roots are not torqued out of the way.
When you have a problem with the apex or you compromise on length and you have a failure then who do you think the patient is going to blame?
I would just show the orthodontist the problem and explain to him what you need.
It wil be easy to give comments if you attach the x-ray of the region but as a rule you just choose and place the implant of dia. and length
such that it should be at least 1.5 mm. away from the pdl of adjecent teeth all around the implant.
I have successfully used mini implants and believe that in this location, you may find it will be adequate.
Joe