Placing dental implant into bone with a slope

Great video showing why bone osteotomy will move towards lower end of slope.  Useful in anterior immediates as well as sloped bone anywhere.

Bill Schaeffer video

Start video at 7:20 to see counter sink method for posterior teeth

1. Drill pilot hole
2. Counter sink large round 4mm bur with highspeed
3. Finish osteotomy normal
4. This allows even off center pilot hole to right self

Start video at 22:00 to see method for anterior immediate

1. Drill divot hole 3/4 up bone wall with small round
2. 23:30 show bur goes in and up and out

Round bur comes in and then up to remove area in dark brown

Where pilot drill exists. Notice it is touching lingual gingiva and is straight up

Placing implants into congenitally missing edentulous sites.

Be sure to scallop the area before placing the implant or the implant will be too high and emergence profile will be off. We see this most often in congenitally missing upper anterior laterals where the emergence profile definitely matters. We also see it in missing lower premolars where the emergence profile doesn’t matter as much.