2 Extractions, 2 Immediate Implants, Bone Grafting | Oral Surgery Techniques #4 with Dr. Gallagher

Key Concepts:

1 – Always review critical anatomy first, tracing the sinus floor, the tooth positions, and existing implants on radiographs before starting surgery.

2 - Engaging the sinus floor 1–2 mm anchors the implant in cortical bone can be advantageous for long-term stability, but going deeper risks perforating the Schneiderian membrane.

3 - Keep at least 3 mm between implants and 1.5 mm between an implant and a tooth to preserve vascularity and prevent bone breakdown.

4 - Plan with the restorative dentist, so extractions, alveoloplasty, and implant positions all serve the final restoration.

5 - Place implants parallel, and let insertion torque (45 Ncm here) decide whether healing abutments can go on the same day.

Key Instruments/Materials:

- Periapical radiographs mapped the sinus floor, the adjacent implant, and the bone at site #13 during planning.

- Elevators removed #11 and #12 while directing force away from the implant at #10.

- Osteotomy burs prepared the implant sites and, left in place, served as paralleling guides.

- Healing abutments were placed immediately because both implants achieved 45 Ncm of torque.

- 3-0 chromic gut sutures closed the flap over the sites.

* Instrument Partner Of This Project – (Looking for a partner with instruments, I'll be talking about and showing the instruments I used in each case)

* Dental Implant Partner - (I place 3 different brands of implants and I'm waiting for my favorite one to partner with me on this project so I can finally reveal it...)

* Bone Grafting Partner - (This could be you! You know who you are lol let me know)

Top 13 Viewers on this Episode on TikTok LIVE 122 Q&A:

1st – Brittany, @codysmom0412

2nd – @kapil3112

3rd – @emmac623

4th – mak, @_makeba

5th – Mads🍒✨, @madisunn96

6th – JuliaJayBird1023, [handle not visible]

7th – @_doctorbell

8th – bovineluvr, @bovineluv

9th – christy07, @christypnw03

10th – Matt C, @matt_c28

11th – Ablahi, @loiytdg456

12th – @user1781291995

13th – brayden💚❤️⚾⚾, @brayden8340

Top Questions:

- With a 3.0 GPA, an 80 CBSE score, and a 60% class rank, should I apply to Oral Surgery residency?

- Have you had implants with crestal bone loss, and did you explant them?

- I want to start placing implants, but it scares me. Where do I start?

- What do you do with a hot mandibular tooth with a big infection when the patient still feels it after an IANB and infiltrations, with no sedation?

- Is $500K too much for dental school?

Now available on:

- Dr. Gallagher’s Podcast & YouTube Channel

My watch in this episode = Citizen Ecozilla Diver (overnight on-call watch in residency)

9.2026

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