Better to Place on 5mm Implant or Two Narrower Implants?

IMO, one 5.0 should be fine.

Go with the 5,(6 if you can get one) why would you want to create something similar to a furcation by placing two implants. Just remember that originally implants were 3.75 with a 4.1 platform and those performed great, there will be no real cantilever effect.

Place 6.0mm x 5.7 or 6.0mm x 8mm Bicon dental implant, they works very good, then you can place an abutment of 6.5mm, forget the original implants, the bicon implants are very good alternative I place them for about 5 years and i dont have problems with them.

Think simple, plan simple and do simple and this will get you out of trouble. Therefore, try not to touch the adjacent tooth to compensate for a awkward situation. With 13mm span, you can comforably place two standard diameter implants such as the 4 or 3.75 and make two promolars as your final prostheses if you don't like to work with one large diameter implants. Large diameter implants are more traumatic to place so it makes sense to place narrower implants.

Contarary to the previous comment on larger diameter implants to be more traumatic i would like to ask whether two narrow diameter implants would not cause even more trauma. . . . . ? better to place a 6mm BICON implant, better than any thing else i've ever seen or done, great variety of abutments to go with irrespective of size of the implant is biggest advantage. TRY IT OUT you'll bemore than satisfied.

Please provide me your email an I will end you x rays of both solutions for you to consider and compare outcomes

I disagree with Dr Wong as I think you need a minimum of 14mm in order to place two 4mm implants. You also need to be extremelly careful to allow at least 2mm separation between the implants and between the implants and adjacent teeth. Why to complicate your life with two implants when a 5mm(diameter)will suffice? My recomendation would be to obtain a Icat scan in order to locate the mandibular canal and once you get to know the vertical and buccolingual amount of available bone then pick an implant size that will fit in the available bone without risking mandibular nerve injury.Try to do a single stage, a 5.0Sx11mm or a 5.0Sx13mm would do. I have used the Astra implant system for a few years very sucessfully.For the restoration, use an Atlantis custom abutment and a PFM crown. Good luck on your case

regarding planning in this case, 2 points should be addessed 1-mesiodistal dimension 2- occlusion with opposing tooth. if u usw 2 implants then we have to put in mind that space required between implants is 3mm & not 2mm as natural tooth,this to prevent the communication between crestal bone resorption if it happened. in case u plan for one implant careful postioning of the implant is important regarding occlusion & design of occlusal surface.

in a 13mm space i would use one implant placed correctly. i would use 2 4mm implants if i have more mesio distal space. remember that for 2 implants you will need 2mm+4mm+3mm+4mm+2mm =15mm. i have now a case with 16mm space i will be putting 2 implants there.

I disagree with Dr.Serge, for 2 implants you need 1.5+3.5+3+3.5+1.5=13. You would also charge the patient for 2 implants and 2 abutments, something to think about.

sorry but 13 is very tight for two. look at the math. 1.5 is too close 2 is minimum 3.5 is not practical since 3.75 is more standard . also that level of accuracy is not practical or predictable or repeatable. so go with one implant of 5mm somewhere in the middle.

I agree 1.5mm is too close, you have to consider the risk factor...i keep half of mm safety anf with a 4mm implant which may be a 3.75 that would give us around 15mmm... Regarding charging a second implant i agree with Dr.Leo...sometimes i have difficulty convincing the patient about putting a second implant but when you have space and the patient agrees better to do it...Anyway it is not the case here Dr.R. is asking about a 13mm case and i am for one implant

3.5 is the next size down with Astra, and it's very easy to convince patients that they need two implants and not one; you just have to show them the x-ray of the corresponding side with a molar having two roots, hence two implants.

please consider 2 one piece implant by imtec 2.9 mm hybrid and put the temporary crown instantly give space to the occlusion, they said that the material is grade 5 ti alloy, u shouldnt worry about the fracture.. i wish or place the wide neck straumann with its trumpet neck, you will get the better prosthetic than with bicon...no fence....