Dentaltown May 2021 - 45
by Dr. LeRoy Horton
Dr. LeRoy Horton completed his
bachelor's degree in biology from
Pacific Lutheran University in
Washington state in 2003, then
earned his DDS degree from the
University of Washington School of
Dentistry in 2007. Having always been
fascinated with dental implants,
Horton pursued advanced training
over the years, attaining fellowships
and completing master's courses. Eventually he earned his
board certification as a diplomate of the International Congress
of Oral Implantologists. He currently owns two practices in the
greater Seattle area and serves our profession as a nationally
recognized AGD instructor.
With its anatomical and aesthetic disposition,
the mandibular first premolar is a good site
to practice immediate implant placement
In my years teaching implants to doctors,
I have observed that most programs-
including my own-start the hands-on
process with posterior edentulous sites. This
is because they present with the least possible
technical difficulty to the practitioner; hence,
they are a great way to introduce a beginner
to hands-on surgical experience.
Once enough repetitions are performed
and comfort is achieved with the basic
principles of implant surgery, the natural
progression is immediate implant placement.
When done correctly, the success rates are
equal to implants placed in edentulous
sites, yet shave several months off the entire
process.1
I have found that the best tooth for this
learning is the mandibular first premolar:
* Molars (upper and lower) can often
be difficult to remove, let alone in
a way that preserves bone, and
creating an osteotomy in the midst
of two to three empty sockets can be
a challenge.
* Anterior teeth present with high
aesthetic demands as well as
anatomical challenges, because
they are often positioned on the
very facial of the alveolar process.
* Upper premolars also tend to be
in such a position within the bone
and this adds a degree of difficulty
to creating the osteotomy in the
correct position.
The mandibular premolar arguably
presents with the easiest anatomical and
aesthetic disposition. This case will primarily
demonstrate the step-by-step process from
extraction to implant placement and discuss
the evidence-based principles at each step. Secondarily, I make the practice-based argument
that the mandibular first premolar extraction
site can be the most ideal site for clinicians
to begin their immediate implant practice.
We will be exploring a case in which tooth
#28 has fractured to the gum line (Figs. 1a
and 1b) and implant therapy was the chosen
course of treatment.
Fig. 1a
Fig. 1b
dentaltown.com \\ MAY 2021
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Dentaltown May 2021
Table of Contents for the Digital Edition of Dentaltown May 2021
Dentaltown May 2021 - Intro
Dentaltown May 2021 - Cover1
Dentaltown May 2021 - Cover2
Dentaltown May 2021 - 1
Dentaltown May 2021 - 2
Dentaltown May 2021 - 3
Dentaltown May 2021 - 4
Dentaltown May 2021 - 5
Dentaltown May 2021 - 6
Dentaltown May 2021 - 7
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Dentaltown May 2021 - Cover3
Dentaltown May 2021 - Cover4
Dentaltown May 2021 - Outsert_SI1
Dentaltown May 2021 - Outsert_SI2
Dentaltown May 2021 - Covertip_SM1
Dentaltown May 2021 - Covertip_SM2
Dentaltown May 2021 - Covertip_SM3
Dentaltown May 2021 - Covertip_SM4
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