Placed these few days ago following surgical guide
Not liking proximity and buccal placement #12
Suggestions please?
you can remove implant #12. wait for bone to grow back then place implant again. i would recommend a skinnier implant. however, if you planned it digitally. how come implant so close on PA? perhaps buccal/lingually they have more distance between them? just on PA they look like they are less than 1mm apart. is the implant 11 and 12? how does the CT look ? also intraorally. when you placed the healing abutment. is the shaft of the driver seem to be on the occlusal for #12? and palatal for #11?
1 Like
Your feelings are correct about the placement.
Restoratively speaking, it will be next to impossible to restore.
Bite the bullet and Explant is your best option
1 Like
You said that you used a guide and if a guide is worth the plastic that it is made out of then the spacing should be fine or else you should consider another source for designing these crutches. Aside from that I feel like this image might be distorted and since the implant(s) are possibly slightly buccal it is playing tricks on the eyes. The image appears to be taken from an angle which will shift any object buccal away from the beam. Consider looking at the case in real time without relying on this potentially distorted x-ray prior to any removal…
1 Like
I think no distorsion, too close each other. Maybe problem with planning, some softwares are more user friendly, some are hard to orient in them. Would not let someone else plan for myself. But if not fully guided, let say only for pilot drill, by widening the osteotomy freehand it can be moved sideways in soft bone. To close my 2cents, from the Xray, I doubt there is enough MD space for 2 even narrow diameter fixtures, but cannot say definitelly from PA.
1 Like
Now the question is “How much do you trust the implant system that you are using”?? If indeed the medialized abutment/platform switching/zero bone loss concept is what it claims to be then you should be fine because there will be “zero bone loss” and this should not be a restorative/esthetic issue. They are only too close together if you anticipate inter-implant bone loss and the makers of todays perfectly engineered discount priced aftermarket devices promise perfection at the crestal level… All of the rules of engagement were developed back when people were still using the old school stuff like the Zimmer TSV that I still use. As long as the manufacturers aren’t blowing smoke this should be fine because these perfect new fixtures don’t get crestal bone loss. I know this is true because the incredibly honest sales folks at Neodent told me so…
1 Like