Dr. A. asks:
I just had a patient back from the periodontist who placed a narrow platform implant in #8 position [maxillary right central incisor]. The implant was placed right into the socket of #8 and is tilted a bit too much to the labial. I usually do not ask for a specific diameter or length of implant. For single units like these I do not provide a surgical guide stent. I am also concerned because the narrow platform implant will be supporting a full size central incisor crown. Will it be strong enough? Will I be able to achieve an acceptable emergence profile?
Narrow Platform Implant in #8: Can I Achieve Acceptable Emergence Profile?
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It will be strong enough. In the hands of a good surgeon (perio, OMS, implantologist) a surgical guide is not needed for the case you described. No you will not be able to acheive an acceptable emergence profile unless you had a very small central to begin with or the implant is buried substantially more than 4mm subgingival. Since the implant is already integrated all you can do is give it a try. Good luck.
I almost always use a narrow platform for 8 & 9. The fact is that with emergence profile, the narrow diameter works to your advantage, giving more bone around the implant for long term stability and also the narrow platform has more flexibilty in restoration if the periodontist has not placed it in an ideal location.
I think the fact that if it is placed too far bucal, it would be a far bigger problem than using a narrow platform implant.
Regarding the first comment I’m kind of surprised seeing D. Levitt saying thet if the surgeon is experienced there’s no need for surgical template. We assume that implants have to be placed EXACTLY 3mm (Coronoapically) from the margin of the predetermined restoration, how is that going to be done without surgical template?This is absolutely a must in order to achieve good esthetic results.
With nobel active Narrow platform I get concerned about the same problem, so it’s a good idea to place your abutment at the time of implant placement, that way you’ll get predictable results.