These Immediate Molars used to be difficult, now with CEREC Guide its pretty “Old Hat”. Looks like #14 is not right for this world. I extracted first rather than going through the tooth just because I was not sure about the quality of the inerseptal bone. Radiographic Guide made with the Large Reference Body. #13 is mobile but the patient wanted to keep it and #15 is slated for a crown in the future, the patient just wanted the molar treated.
Scanned with CEREC planned the implant drill to be just short of the sinus floor. Because of all the bone loss and root sockets I did not plan on doing a Summers lift with Osteotomes I just wanted the apex of the implant to lift the membrane:
Drill Body Milled, Always check the underside to make sure that it seats and is flush with the indentation that the Reference Body made.
Using the Nobel Keys, we went through the series up to the 4.7mm drill which would be used on a 5.2mm implant. Next we used the Crestal Bone drills:
Shaped the socket with the drill and in went the Implant, 7 by 10 HA coated. Note how huge that implant is in widt
Down to length, equip-distant from the adjacent teeth contacts. We lifted the membrane with the implant, which should form a floor over time. Again, #13 has a widened PDL due to mobility and the patient is aware, #15 will be treated in the future.