Thoughts on this implant placed in a grafted site . Bone was surprisingly very dense was able to place nicely into inter- radicular bone . Just would have ideally wanted .5 mm deeper however I believe this will be good long term and there is very good connective tissue present as well . Thank you
I think you answered the question when you stated that " [quote=“chiefdds, post:1, topic:1563”]
there is very good connective tissue present as well".
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Sure it would be nice to have it placed a little deeper to account for the emergence profile originating from this small connection but given the situation I think this will be just fine.
the surface roughness or microgrooves or any other special micro design element you may have on your implant at the implant platform/shoulder supracrestal can influence your outcomes. until your implant is under loading or function you cannot be certain of it’s marginal bone loss or remodeling.
Since by your own admission you would like to have this placed about .5mm deeper something to consider is switching to a parallel walled fixture instead of this sharp tapered design. With a parallel fixture you can over drill the osteotomy by 1mm or so and use this as leeway to fine tune the depth of the final placement. With a tapered fixture, such as the one you placed, it is a wedge inside a wedge and it doesn’t afford any back and forth fine tuning without sacrificing stability or potentially over torqueing the fixture. Tapered fixtures are nice and they certainly have some advantaged but the parallel walled design allows for tremendous freedom for fine tuning and can eliminate this frustrating situation.
pass grade. but to be perfect. i think your angulation is little too distal also. you have plenty of space apically. so kinda confused as to why you didn’t place the implant deep enough. is this a 5x10mm?
I m going to speculate that he chose a length for the fixture that he wanted and with focused tunnel vision drilled a hole to that exact depth then placed a screw in that hole. I am guilty of having done the exact same thing many times, in fact I was trained to do just that some 20 years ago with tissue level fixtures and non platform switched bone levels. The real problem is the use of universal platform, usually 3.5mm, in posterior sites… I will never question this placement only the choice of hardware that was placed