Lower front teeth can be complex implants. Many dentists only focus on the upper front implants and there is not much talked about lower incisor immediate implants. They are usually complicated because the space is very tight. Natural lower teeth are very skinny and oftentimes people have crowding and or periodontal gum disease of these lower incisors. If they are just the tiniest bit crowded they become almost impossible to place an implant without getting too close or touching one of the adjacent roots.
Most implants for the lower incisor are in the range of 2.5-3.2 mm. I would not advise mini dental implants for these areas as they are weak and can bend and break off. They are consider temporary implants
In this case I was able to remove a single broken root canal lower front tooth incisor. On the same day, I placed an immediate dental implant into the socket with a small bone graft to fill in the void between the implant and the existing socket bone wall.
The patient was able to leave that day with a fixed temporary. The only thing he needed to worry about was not to chew in that area for 4 months while the implant undergoes the osseointegration process and becomes more solid. After 4 months, I took impression with shade matching tabs and made a new final crown for him. Pain is minimal… Usually you would only need ibuprofen.
He was fortunate and that even though his teeth are skinny they were well aligned so replacement was more straightforward. Sometimes if one or 2 of the lower incisors are crooked or “bad” it is better to remove 4 of them and place 2 on each side with a dental implant bridge.
Sometimes computer guided placement is necessary in these very tight spots.
Because of good planning and treatment, the patient regained all gum triangles ( papilla) through proper forming and shaping of gum tissue. This leads to a nice result and not an implant that is too long at the gum line.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry