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Justin posted an update
When placing two immediate implants for a mandibular overdenture how deep sub crestal would you recommend to place the implants?
Erick and Jedediah7 Comments-
For implants I place for overdentures I prefer to place them more subcrestal than other implants. Typically 2 to 3 mm below the crest of the bone. Over the years I just find I have better overall crystal bone and less issues and more compromised patients as bacteria tend to leak down those locators more frequent overtime and this helps prevent that and has healthier thicker tissue as well
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For immediate implants do you prefer to place in the lateral socket, canine socket or interproximal bone between? For my case I have plenty of vertical bone but the width would be a little tight for a 4mm diameter implant in the lateral location but I would have more room in the canine location. I do have a 3.2 diameter implant I could place in the lateral location. Do you think a 10mm length is adequate or since I have enough room would 11.5 be more beneficial?
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It just depends. Sometimes I use the socket sometimes I use the interproximal bone. The interproximal bone can have much more porous bone and poor quality bone so it depends on the patient, bone quality and anatomy. Maybe between canine and lateral area for spacing if bone is ok.
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How far would be too sub crestal?
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Hard to say what would be too deep. But with deep and tissue I believe stock locators only go 7mm tall but I’m not positive off hand. Typically I would typically not go more than 3mm deep on healed site and 4 to 5mm on immediate sites in terms of maximum depth but I’m not typically at those depths
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Here are some screenshots of the CT for the case I am planning. Should I be concerned about the circular radiolucent area below 22 on page 2? When I traced it back I only saw it in a few segments. I remember Ivan saying there could be anterior branches of the IAN or vasculature in this region.
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From what I see here it looks ok. You just want to be aware of any possible loop the IA can make exiting the mental foramen as with as mandible midline and it’s associated foramina.
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