What am I, Job? 2 Implants Planned, 1 Implant Placed

Here is a case that could have gone smoother.  Had a bit of a weird week, one room went out, had an inlab case that did not work out, and then this one.  #31 missing, #28 old endo with a perf and lateral lesion requiring extraction.  Should be nice an easy, right?

Planned the case for an Optiguide.  Note the angulation of the teeth per the Curve of Wilson.  Pre-molars on the lower tip to the buccal and molars, to the lingual.

Punched #31, #28 as almost predicted, came out in little chunks.  I always try to avoid removing bone, but I was working on this until the last 1mm.

Limited opening on this one. One way around it is to “pre-load” the drill into the handle and angle it into the guide sleeve.

#31 went in easy enough.  Tipped to the mesial per the Cure of Spee.

After a lot of back and forth we ended up aborting the Implant on #28.  The socket kept pulling the osteotomy mesial, the bone reduction during the extraction led to a wimpy buccal plate, and there was just no stability.  Placed a Contour Healer on #31 and rushed a slipper from the lab.  Will come back in 3 months and try again with a CEREC Guide.