Implant #19 with bone graft 3

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Case presentation: 

Case presentation Mandibular molar implant with limited bone

“I want teeth to chew with”: 

“I want teeth to chew with” 50 year old female presents with b/l mandibular edentulous spaces. Wants fixed implant restorations.

CT Scan reveals limited bone #19 area: 

CT Scan reveals limited bone #19 area Vertical height on bucal only 6-7 mm to nerve

Limited height and width: 

Limited height and width Width at coronal aspect 4-5 mm

Plan for #19: 

Plan for #19 The implant would serve as tent pole to keep pressure off bone graft. Titanium reinforced membrane would supplement tenting effect. Plan to build 3-4 mm on vertical bone on bucal aspect of implant. Place implant with bone graft. Implant to be left above bone to build vertical height of bone.

Surgical Procedure for implant #19: 

Surgical Procedure for implant #19 Crestal incision, full thickness flap Osteotomy for 5 mm x 10 mm implant Three threads left exposed initially on bucal

Bone graft added with non-resorbable, titianium reinforced membrane. Primary closure. : 

Bone graft added with non- resorbable , titianium reinforced membrane. Primary closure.

Post-op x-ray shows implant above nerve, membrane tacks in place to immobilize membrane, and bone graft.: 

Post-op x-ray shows implant above nerve, membrane tacks in place to immobilize membrane, and bone graft. Planned Actual