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#10 implant site
#10 is planned for a 3.2x10mm implant. The socket was grafted about 4 months prior to the CBCT. I skewed it more towards the palate to ensure the 1.5mm buccal bone (which I believe is more important to have that thickness on buccal rather than the palate). I do have 2+mm buccal bone in the incisal 4mm of the implant. My concern still is the thinner palatal bone (on the right side in the picture). I do know that the palatal bone can be thinner due to the thicker palatal tissue and hence better blood supply – BUT how thin is too thin?
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5 Replies
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You are totally right that palatal bone is less likely to get resorption or peri-implantitis and that most problems occur on the buccal. However, as a periodontist I often get cases sent to me where they went too palatal and now there’s no palatal support for the implant. 1.5-2mm buccal and palatal is a recipe for success in my book.
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Thank you for providing a video explanation. These are awesome!
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You’re on the right track with your planning. Prioritizing at least 1.5mm of buccal bone is crucial, and having over 2mm in the incisal 4mm is definitely a positive. As for the thinner palatal bone, you’re right that the thicker palatal tissue and improved blood supply can compensate to some extent.
However, when palatal bone starts getting below 1mm, that’s where I get cautious. The risk of resorption over time increases significantly, especially in areas with thinner bone. If you’re concerned, you might consider slightly under-preparing the osteotomy.
Ultimately, if you have good primary stability and the soft tissue is favorable, I’d say you’re in a good position, but monitor that area closely over time. Thin palatal bone can work, but below 1mm consistently would make me hesitate. If you have a think biotype of soft tissue then your prognosis will be much better!
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Thank you everyone for your input and help!
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