Dental Implant In The “Aesthetic Zone,” Bone Grafting | Oral Surgery Techniques #2 with Dr. Gallagher

Key Concepts:

1 - Width vs. Length Trade-off: Apex concavity forced a shorter 8.5mm implant (10mm planned) at 3.75mm width to protect the buccal cortex

2 - Reading Anatomy Beyond X-Rays: Apical concavity wasn't visible on imaging — confirmed only by drill palpation

3 - Spacing Guidelines: 1.5mm implant-to-tooth, 3mm implant-to-implant — both maintained

4 - Aesthetic Angulation Challenges: Bone limits required a compromised trajectory, corrected with a multi-unit abutment (15°–33°)

5 - Buccal Grafting Technique: Thin periosteal reflection via sulcular incision to tuck a 50/50 cortical-cancellous graft for added contour

Key Instruments & Materials:

- Osteotomy drills — sequential prep, monitored by feel to avoid apical perforation

- 3.75mm x 8.5mm implant fixture — sized to bone constraints

- Periosteal elevator — used for thin, careful reflection during graft placement

- 50/50 cortical-cancellous graft — buccal surface augmentation

- 3-0 chromic gut suture — closure

Instrument Partner Of This Project – (Could be you! Let me know)

Top 10 Viewers on this Episode on TikTok LIVE 117 Q&A:

1st – H.D., @class.of2022

2nd – GeorgeAnthony Kuttab, @georgeanthony.kut

3rd – lilyana, @lilyana2908

4th – Alain, @alain_0000

5th – nonickname, @buddifkusok

6th – Simon, @simonphm_12

7th – Lucyann58, @lucyannlester

8th – @dentalguy123

9th – Sadeem, @smalllevel_

10th – sena, @user171005270

Top Questions:

~09:10 “Do you need an implant?"

~09:45 "How long for the socket to heal after upper wisdom tooth removal?"

~10:15 "Would regular implants work for a trans patient?"

~10:45 "How hard is it to get into med/dental school?"

~11:10 "Does an MD matter for hospital-based OMFS?"

Now available on:

- Dr. Gallagher’s Podcast & YouTube Channel

My watch in this episode = Citizen Promaster Diver Day Date

9.2026

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #oralsurgeon #doctorgallagher #doctorgallagherspodcast