Virgin tooth #4 in this 60 y.o. male fractured vertically and was extracted atraumatically. Immediate implant placed to the crest of buccal bone or about 3mm below the gumline. Socket was thoroughly curetted out, but no osteotomy drills were ever used because the socket had almost the perfect dimensions to place the 5.0 X 11.5mm implant. Handpiece insertion torque was 45 NCM with a ratchet driving the implant the final 2mm. Gap between implant and buccal bone was less than 2mm, so no bone graft used. Immediate temporary placed and kept out of occlusion. A week of antibiotics was given followed by another week of a different antibiotic because the area never stopped hurting. Ultimately the implant became loose and I removed it with my fingers. Does anyone know why this failed to integrate?
extracted tooth #4
immediate temporary – note not in occlusion. Also note excellent tissue adaptation giving high hopes for aesthetic final result.
implant with temporary removed three weeks later using fingers only
pre op x-ray tooth #4 with vertical root fracture.
final x-ray with temporary same day as surgery
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