Just placed a couple of BLT and once again my immediate post-op and have my lovely apical radiolucency. I’m clearly a master clinician. Finally I may have worked out the reason for this. I’m using straumann velodrills and placing BLT implants, as previously advised by the straumann team this is not an issue. Due to morphology of the drills vs the morphology of the implants this may be the reason for the radiolucency ? Does anyone concur, have I cracked it ?
Absolutely. The implant has more taper than the osteotomy drill so you are seeing the overprepped apical portion as a radiolucency. In the attached photo you can see where I intentionally overdrilled my osteotomy to allow for some fine tuning of the final placement of the One Stage collar. At least you shouldn’t have to be concerned about pressure necrosis since you have allowed for some relief at the apex.
Is there a particular reason that you choose to place cover screws and submerge these fixtures? I understand that a lot of docs routinely submerge and treat in two stages but I have never felt good about doing a second procedure just to uncover a fixture. Fortunately the smart folks at Straumann demonstrated years ago with the TL implant, possibly the most successful fixture of all time, that it is not necessary to submerge and treat implants in two stages so I have always ran with that philosophy. Just curious where you stand on this…