Those immediate molars are coming out of the woodwork. Very hard to do free hand, very easy guided. #31 is a bridge abutment with a large buccal abcess and extensive bone loss in the furcation. Did not have time to do this in CEREC guide or even scan intra orally, so my staff took an alginate, poured it and I imaged with the Extra Oral function in Omnicam.
No real proposal in cerec, just drew a little circle in Manual Margin marking and kept hitting the arrow forward. Planned both implants in 30 and 31 just through the model.
SICAT removed the teeth on their side, so I sectioned the bridge, extracted #31. Got that granulation tissue out later.
Punches and the lance bur are pretty short so sometimes you have to use the extender. The shank on the lance is 2.8mm so use that key. I knew from the Cross Sectional slice that we had some D2 bone so I was ready with the lance.
The rest is pretty easy. I did not section and flatten the molar as I knew I did not want to reproduce the tipping like 32. So I new I would be in the mesial socket. I will recontour the gold crown later, I did not want a lot of gold shavings in the socket.
I knew the bone was hard, but I wanted to try the implant in first before the Crestal Bone Drill (Dense Bone Protocol). Sure enough the implant torqued out too coronal, so out came the Crestal Bone drill and easily down to length at 45Ncm.
Nice long 11.5mm implants. I got #31 down another 1mm apical after the film.
I know, broken record. MFDBA around the fixture mount, place a hole in the membrane with a 558 bur and screw it down with the healing abutment. These will be replaced in 2 months with contour healers. I don’t know why but I booked 3 hours so I would not be rushed. Even with a lot of photography we were done in 45 minutes.