Hello. I am planning for implant placement at 46 region. Extraction was done almost 5 months ago. CBCT report shows buccal wall defect. 9.8 mm distance from IAN to 2 mm below the crest, where bucco-lingual width is 8.1 mm (2 mm below the crest). I am planning for 5×7 mm Dio UF2 implant. Will it be a good choice? Looking at the images is there any chance of GBR? Kindly guide
Hi reviewing the case is a bit tough without further imaging but based on what you are showing a few things.
-You are saying you are measuring 2 mm below the crest for about 10mm so you have about 12 mm–which means you can probably place a 9 mm implant but it would be nice to see your virtual placement and IAN marked on the scan. You may be close to IAN or it may not be in the placement area. CT scan is great but learning virtual placement so you can play around with length, width, angulation etc is always key to getting familiar with process
-cant tell the density of the bone graft but you should be able to obtain those measurements from the scan. There are some apparent voids. You won’t know quality until you create osteotomy an assess. It is possible you may need to remove graft that has not take or add more.
-if you play around with virtual placement and have ideal and centered placement it is most likely you will not have to worry about buccal GBR but should always be prepared to do it.
Hope that helps,
I’d place the short implant as long as the osteotomy is good, making sure there are no voids.
ALWAYS have some bone ready for buccal GBR in cases like that. That wall will be thin at the crest and will tend to resorb.
If you are planning on placing 2.1 mm beneath the crest then that only leave you a little over 1 mm before the nerve. I would place it slightly below the crest and not a full 2.1 mm below the crest. Looks like you have adequate width. Then you would be further from the nerve.
Even if you are getting help in the planning you should go through virtually placing the implant. So in your planning software you could virtually place the implant and make measurements off of that. When I initially review the scan I do the measurements like you have quickly just to make sure this is an area that is possible for an implant or if grafting etc would be needed. Then I would drop the virtual implant in and make sure all parameters for proper implant placement are there. Bone density,distance from crest, distance from other teeth, distance from nerve/sinus, amount of bone on facial/buccal etc
Hope that helps.
Thank you so much Doc..
Thank You so much Doc..