Implantology

A 28-year-old woman with a hopeless maxillary central incisor due to vertical fracture requests an immediate implant and same-day temporary. Buccal plate is intact; thick gingival biotype; good bone apically; no acute infection.

A 63-year-old man on well-controlled type 2 diabetes (HbA1c 7.0%), nonsmoker, needs a mandibular premolar implant.

A heavy smoker (20 cigarettes/day) seeks implants in the maxillary anterior. Soft tissue thin; high smile line.

A 54-year-old on oral alendronate for osteoporosis (5 years) requests a mandibular molar implant. No cancer therapy.

A 45-year-old needs an implant in site #36 with 7 mm ridge width and adequate height.

You plan two adjacent implants in the esthetic zone.

A 68-year-old with prior 60 Gy radiotherapy to the mandible (3 years ago) seeks implants in the irradiated field.

During lateral sinus augmentation, a 3 mm Schneiderian membrane tear occurs.

Posterior maxilla with residual bone height 5 mm under sinus floor; single implant planned.

A 34-year-old requests immediate molar implant at #46 after acute apical abscess; furcal bone compromised.

You aim for immediate loading of a mandibular canine implant.

A patient on apixaban (BID) is scheduled for two-stage implant placement.

In the esthetic zone, you plan implant platform depth relative to the planned facial free gingival margin.

A 52-year-old bruxer needs full-arch implant rehabilitation.

After second-stage uncovering, 0 mm keratinized mucosa remains buccal to a mandibular implant; hygiene is difficult and painful.

You are planning an implant near the mandibular canal.

A 40-year-old presents with peri-implant mucositis (bleeding on probing, no bone loss).

A different patient has peri-implantitis with 4 mm crater-like bone loss and suppuration.

A 57-year-old maxillary first molar site shows 8 mm RBH and 9 mm width.

Immediate implant in a mandibular incisor with fenestrated buccal plate discovered after placement.

Anterior maxilla: you plan abutment material for thin tissues with high smile line.

A patient demands “same-day full-arch” maxilla on four implants (All-on-4). Primary stability achieved: 45 Ncm anterior, 35 Ncm posterior.

During implant insertion, torque suddenly drops and the osteotomy feels widened.

Implant crown screw loosens repeatedly despite recommended torque.

A cement-retained implant crown develops peri-implantitis shortly after delivery.

You plan immediate placement in #21 with thin buccal plate (0.6 mm) on CBCT.

Mandibular overdenture on two implants—patient complains of midline denture base fracture.

A 59-year-old with generalized Stage III periodontitis now stabilized wants implants.

Provisionalization plan for anterior implant to sculpt papillae.

A patient has persistent dull pain and paresthesia after implant placement near mental foramen (no signs of infection).

On CBCT, the anterior maxilla shows a large nasopalatine canal occupying much of the ridge at #11.

Immediate molar implant planned: septal bone measures 3.5–4 mm width and 10 mm height; socket walls intact.

Patient with titanium allergy concern requests “metal-free” implant.

A full-arch fixed case shows 18 mm A–P spread and planned 16 mm cantilever.

After GBR at #24, the patient returns at 2 weeks with early membrane exposure (resorbable collagen), no purulence.

Torque control question: manufacturer recommends 25 Ncm for abutment screw; clinician torques to 40 Ncm. The screw fractures.

A patient with implant crown complains of “clinking” and mobility of the restoration, but the implant is stable.

You plan staged horizontal ridge augmentation (3–4 mm deficiency) in anterior maxilla for ideal implant positioning later.

A two-implant mandibular overdenture with locator attachments shows frequent insert wear and retention loss.

At 6-month follow-up, a maxillary anterior implant shows 1.8 mm crestal bone loss since loading, with bleeding on probing.

A 61-year-old has a displaced implant seen on CBCT within the maxillary sinus one week after lateral window augmentation; mild sinusitis symptoms.

During immediate implant placement at #31, brisk sublingual hemorrhage elevates the floor of mouth.

An edentulous 78-year-old with severe mandibular atrophy (vertical height <10 mm) seeks two implants for overdenture.

After extraction of a maxillary lateral with thin buccal plate and 5 mm dehiscence, the patient requests immediate implant for esthetics.

A healthy 42-year-old presents for single posterior implant. Antibiotic policy?

A 55-year-old receives a mandibular first molar implant crown; you must design occlusion.

Limited interocclusal space (4 mm from implant platform to opposing cusp) is present for a premolar restoration.

Full-arch mandibular case on 6 implants requires definitive impressions.

After tilted posterior implants for All-on-4, you need to correct screw access angulation for esthetics.

Immediate provisional in #11 creates blanching and recession at 4 weeks.

A 38-year-old shows midfacial recession around a stable anterior implant placed too facially.

Pain localizes to the apex of a new implant placed adjacent to a previously endodontically treated but symptomatic tooth; CBCT shows apical radiolucency contacting implant apex.

Three months after placement, a posterior implant is mobile without infection; insertion torque was 20 Ncm; patient chewed hard foods early.

A crater-like circumferential peri-implant defect (intrabony 3-wall) with 5 mm bone loss and no major mobility.

Removal of a failing maxillary implant with minimal bone loss is planned.

Soft bone (D4) encountered in posterior maxilla during placement.

Guided surgery is planned using a tooth-supported guide; you worry about accuracy.

A 64-year-old with history of periodontitis, now stable, asks about maintenance after implant restoration.

You must choose implant–abutment connection for posterior load.

A patient with severe gag reflex cannot tolerate conventional impressions for a single implant crown.