immediate implant placement

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Categories ; Immediate placement , Nobel Biocare, grafting,

flapless, prototype

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Fracture of lingual cusp. Patient in pain, just before the weekend. Total treatment

time from diagnosis to implant and natural tooth pontic : 90 minutes

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Note lingual cusp missing, ideal implant axis assuming buccal resorption after

extraction.

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Prototype BLP ( Bucco lingual positioner)

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Correct mesio distal position, Regular diameter.

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Estimation of the trajectory of the implant. Tungsten Ink prototype. Actual parts

are radio opaque.

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Crossbar removed, exposing the retention rails

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Incorrect X-ray direction, double RIR’s visible

.

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Correct X-ray direction, RIR’S overlap. A 3 degree rotation block is indicated, so

we’ll have some fresh bone on the mesial aspect of the implant. A 7 degree

rotation-block would follow the root space and potentially have less initial stability

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Epithelium removed from sulcus with diamond bur

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2 mm drill diameter at 10 mm length . Color of the Flexistop has since changed

to red for 3 mm

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Drilled to 10 mm length

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10 mm length

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2.8 mm drill diameter at 10 mm length

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3.25 mm drill diameter at 7 mm length. The implant is a tapered implant requiring

a step back preparation

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Tap for Nobel Active Implant

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Grafting the socket

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Guided implant delivery.

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Prosthetically driven implant placement

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Additional grafting and socket seal with collaplug and cyano-acrylate tissue glue

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Natural tooth pontic

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Implant placement, good initial stability. Implant did not follow socket precisly as

planned

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Healing within normal limits, with appropriate ISQ reading at 3 Months