[Diagnostic / Planning]  Location-location-location (24)

 Location - #24 - in a healthy 35 yr old male . Tooth lost due to root fracture. . Delayed bone grafting was performed in the site previously.

Location -- I am referring to the preferred angulation of the  fixture. I am enclosing 2 proposals for fixture positioning. And I am considering 2 different sizes -- 5x10  or 5 x8.5 .

1. If I follow angulation of roots of natural teeth, a screw retained  crown  is  more achievable , with occlusal opening to screw access hole  being in central fossa of crown .

2. If I parallel implant to bone ridge, occlusal opening access for crown is thru buccal cusp, .

I would appreciate some help as to my best choice .

3. As to length, I am avoiding sinus lift , but certainly can consider  a small sinus 'bump' , or even a small lift if it improves the prognosis.   A 4.5 mm diameter could be considered , but it seems bone is adequate for a 5 mm dia.

by Madeson Basie at Thu, Jun 29, 2017 9:11 AM

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Mark Kwon Replied at Thu, Jun 29, 2017 9:57 AM

Hi Madeson,

maybe answer lies in between the two?

Too buccal- access is too buccal

Too palatal - end up w buccal ridgelap

As long as the implant is within the buccal envelope and depth is appropriate, you should be fine. 

I Usually use 4.0 rather than 5.0 for premolars. 

 Thanks for the upload!

- mark