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.