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Second Molar Dental Implant #18 with Extraction and Bone Graft

A failing root canal caused this.  The root canal was leaking and not done so well to big with.  This is a lower second molar #18.  The opposite side would be tooth #31.  This is typically the last molar in the mouth on the bottom jaw.

Failing Root Canal
Failing Root Canal with Infection -3D scan



  • #18 molar pain when biting, crown loose, infection
  • Poorly done root canal
  • Vertical crack


  • Second molar restricted mouth access and longer implant needed if immediate can be done (told him 50/50 chance of immediate)  Other option is a socket bone graft and come back a few months later.
  • Minimal  bone to engage to immediate implant
  • Infection at the apex of the failed root canal.
  • Fearful patient!
Confirm Angle of Implant with drill


I will allow the implant to heal for 4 months, then I will make a custom abutment crown with ideal contours to prevent bone loss in the future.

Doing an immediate molar saved this patient at least $500 and did not lower the chance of success.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

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About Ramsey A. Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.