Techniques for ideal implant placement in the mandibular first molar position

Implant restoration of the mandibular first molar can be particularly challenging because of the heavy occlusal force exerted on this tooth. Bone quantity and quality, as well as fixture characteristics, play important roles in the long-term success of any implant. In this article, techniques for the ideal placement of an implant in the lower first molar site are discussed for both abundant and moderate bone quantity and for bone quality that is either moderately or minimally dense. Placement depth and the benefit of using a commercially pure grade 4 titanium fixture for mandibular first molar restorations are also discussed. In cases where adequate supporting bone exists, wide-diameter implants can offer an advantage by anchoring the implant into more dense bone that is concentrated toward the outer edges of the underlying bone. These implants also provide greater surface area, which reduces the amount of force directed to the underlying bone and may increase the long-term prognosis of the implant.