This patient has had an implant placed overseas. It is a MIS 3.3mm implant. Now he wants it restored.
My cencerns are....this is a 46 being supported by essentially a mini implant. Too much occlusal force!
1- go back to whoever put the implant in.
2- place a premolar with a large gap between the "46" and the 45 to clean.
3- place another 3.3 implant and splint them together.
I appreciate your comments assuming that patient can not go back to previous dentist.
by Keyhan Alavian at Sat, Dec 16, 2017 9:06 AM
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Ho-Young Chung Replied at Tue, Dec 19, 2017 1:16 PM
I'm assuming going back to the original treating clinician isn't really an option as it was overseas.
The patient needs to be advised (if you haven't already done so that is) that the fixture is too small to support a molar. I would even hesitate putting in a premolar crown. Splinting to another fixture will be difficult. If you place another fixture mesial to the current fixture, you will have them converge. Taking an impression will be difficult and so will be restoring them with ideal contours and cleansability.
I would personally remove this implant and place a proper diameter implant (5mm) in the correct position for 46. If you are lacking BL bone width then GBR may be required prior to fixture placement.