Is an immediate implant possible in this region?

sure why not? Depends on bone available, depth, width etc.

Definitely yes

of course. Probably will require some grafting as well

What?-help me out here doctors. Where is the bone to engage post extraction? If he attempts to place it into palatal bone the angulation will be poor for restoring and function. The roots are not seperate and there is nothing beyond the apex but sinus? What's the rush-graft and place post preservation.

without primary stability, the implant will fail. So many things to consider before just saying yes to immediate implant, and you wont know until you extract the tooth, and see if you have four intact walls. Best tell the pt that you will likely have to graft and wait, unless the pt is very lucky and all stars align. Good luck.

I agree with hedieh.

And don't forget 3D evaluation to know with more certainty how much bone is available in space... An extended 20 yrs + (?) restoration should be able to wait a few months for a more predictable result...

A routine procedure; atraumatic extraction, small diameter implant (2.0X13mm) angled palatally through the approximate midpoint of the tooth socket palatal wall I-G, graft socket (RE-Oss), suture tissue, place composite temporary, 6 weeks healing time, impress for permanent restoration, evaluate ,adjust and cement permanent crown. A nearly everyday procedure. Good , predictable results and happy patients.

Take 3D then evuate. Yes or No to immediate implant is not possible without 3D first.

2.0x13? Who makes those? Not a two piece

assuming from the insufficient xray details (cbct in this case due to sinus proximity )no it is not possible to immediately place an implant here. Two questions-where is the 3-4 mm of apical anchorage going to come from? where is the width available to place a wider implant that the tooth extracted - mesial distally its pretty tight to the adjacent teeth. Extract and graft properly and use a nembrane and suture well followed by glustitch. Go back 4 months later and use a Versah drill technique to implode the sinus 3-4 mm and now you can get your 3.5 or 4 mm by 8 or 10 mm deep implant in there and it will work.

Yes, with 3-D evaluation of available bone and restorative outcome. A traumatic extraction and implant system selection for initial stability.

Agreed with hedieh, after 3D evaluation

Non restorable? I would treat this tooth routinely with endodontic treatment and a crown . If you decide to remove the tooth it could be restored with an immediate implant almost always.

Yes it can be done with lateral engagement by little use of linderman drill and follow soft bone osteotomy protocol for all active implant . Remaing lateral space can be managed by jumping distance protocol.

First, 25 is a bicuspid,#13 in US numbering, so yes 1 Implant is sufficient. The Implant I referenced is a 2.0X13mm MDL by Intralock, a one piece implant. I do the procedure described multiple times per day and have hundreds of sucessful restorations, as do many other colleagues, so the debate about whether it can work has been settled years ago. Technique can be learned through Shatkin First, Amherst, NY or the International Academy of Mini Dental Implants (IAMDI). The future already arrived. Alan Robinson DDS MAGD FADI DICOI DIAMDI

Not as easy as it might seem. Without the skills and experience your implant will end up touching the adjacent root . Perhaps it can be done ( we have limited info to make that call ) but should it be done in your hands. That’s the question we need to face everyday

3d image, if all bony walls intact, atraumatic extraction, any 3.5 or 4 mm by 10 or 11-11.5 mm fixture will be more than sufficient. If you achieve decent primary stability, by engaging floor of sinus or even some manipulation, graft all voids, mobilise soft tissue, suture well to prevent encapsulation, place a Maryland temp and wait 4-6 months. If you want, do a drilling guide for best possible prosthetic outcome. It works well every time, done hundreds. Yes we could be "traditional" in our approach but at the end of the day the patient would need two surgical procedures and increased cost. As Alan Robinson very well said, "the future already arrived" embrace it. Respectfully ST