Problems can be avoided during implantation procedures only by evaluating the different quantity and quality of patients’ bones and by applying the proper standards according to each situations in the case of implanting to the lower jaw posterior.
1. Evaluation of bone quality
① Patients’ age and gender: Surprisingly, many older patients have hard Grade Ⅰ~Ⅱ.
In the case of female patients, they may have to take an osteoporosis test.
② Elapsed time after tooth extractions: Approaches should be different depending on the passage of time – immediate, delayed immediate or delayed - after tooth extractions. In the case of delayed immediate, in particular, it is not so difficult to perform an implantation because the cortical bone layer hasn’t been fully formed.
③ Whether or not there is bone augmentation
④ Decision to choose an open method to form flap or a flapless closed method
2. Confrontation in embarrassing situations during implantation
One of the common situations experienced in the lower jaw posterior is that the final 3~4mm part is tightly jammed while inserting the implant body after reaming. It is very important to prevent such situations. It also is important to insert more than 2/3 of the body with the power of the hand while implanting the body after reaming.
If strong resistance is felt at the cortical bone, the implant should be taken out and the next stage tap should be applied.
If such a procedure is applied two or three times, the procedure can become much more gentler.
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