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Single Tooth Implant Immediate PlacementDr Sanjay Bhikaji Sawant

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Content1 Implant Anatomy2 Patient Details3 Chief Complaint4 Patient History & Examination5 Treatment Options6 Clinical Evaluation of Implant Site7 Treatment Plan8 Implant Procedure9 Patient Instruction10 Implant Maintenance11 Pre & Post Treatment

IMPLANT ANATOMY

Patient DetailsPatient Name Mrs Pooja Sutar Age 36 yearsSex FemaleMariatal Status MarriedOccupation Housewife

Chief Complaint Patient wants to replace her broken tooth in the upper right tooth region

Past Dental History

Extraction of lower right first molar two years back

Copmposite Restoration with 11 ,21 and 22

Past And Present Medical HistoryNo relevant past and present Medical History Reported By Patient

INTRA-ORAL EXAMINATION

Extraction of root pieces of 14 planned followed by immediate placement of Implant

Pre-operative Root-piece of Upper Right First Premolar

Occlusal View Pre-Operative

Clinical Evaluation of Implant SiteSPACE EVALUATIONMesio-distal Dimension 8 mm Bucco-lingual Dimension 7 mm Inter-Occlusal Distance 5 mm

RadioGraphic Evaluation

Bone Height 15 mm

Treatment Plan

According to clinical and radiographic evaluation, root form endosteal implant 3.8 x 12 mm planned for 14 region.Atraumatic Extraction Of Root Piece of 14 followed by placement of Implant followed by filling of jumping gap with Bone Graft covered B Membrane.

Two Stage Surgical Technique planed followed by closed tray impression technique for prosthesis.

Implant Procedure

Procedure

Local Anaesthesia Buccal and Palatal Infiltration GivenNo.15 Blade is used around crevicular area of Root Piece . Sequential Use Of Periotome is used as per Concept of Atraumatic Extraction Technique .

Application Of Periotome

After Removal Of Root piece Piolet Drill used with length of 12 mm followed by X-Ray to confirm Angulation .

Osteotomy is further widened by 2.5 mm and 3.2 mm diameter Drill with length 12 mm.

Implant of 3.8 mm Diameter length 12 mm inserted in osteotomy site . Final torque of 35-40 N-cm used .

Atraumatic Extraction TechniquePericisionApllication of Elevators and periotomesForcep applicationSocket DebridmentSocket Inspection

Bone Graft (Nova-Bone Putty ) is firmly packed to fill all the jumping gap , followed by copmlete coverage of graft by Resorbable Collagen Membrane followed by tension free water tight interrepted sutures to close the site .Healing Cap Placed.

Post-Operative IOPA taken

PROSTHETIC PHASESecond Stage Surgery

Patient was recalled after 3 Months Infiltration administered Inspectd for any soft or hard tissue adverse changes occurred .Remote crestal incision given with need to expose cover screw .Irrigation with Betadine Done at cover Screw Region . Cover Screw Is removed with the aid of Hex driverGingival Former / Healing Abutment is selected as per criteria .Gingival former placed confirmed fitting in IOPA .Sutures placedPost-op instruction and medication prescribed .

Impression Making

Patient Recalled after 15 days .Inspected for any Soft or Hard tissue unwanted Changes .Gingival Former is removed with the aid of Hex Driver .Abutment is selected as per criteria .Abutment is seated on Fixture and proper tight joint confirmed in X-Ray .On confirmation abutment removed and replaced by Transfer Abutment Coping .Closed Tray Impression Technique selected .3M Express XT2 VPS Soft Putty And Light Body Impression Material Chosen .

Appropriate Tray Size Selected .Soft Putty is Mixed In Hand Simultaneously assistant dries area of impression and light body with aid of gun is loaded over area of interest . Putty Mixed loaded in tray and placed in mouth .Once Impression Material Set it is removed .Impression removed from Mouth .Transfer coping is removed from mouth and seated in tray .Click noise confirmed .Implant analogue is seated in coping and whole assembly send to the lab for further Prosthesis Fabrication .Healing screw placed in Mouth OHI given to patient .

Well Formed Gingival Cuff By Gingival Former

Abutment Fitting Checked In X-Ray

Crown On Cast Facial ViewCrown On Cast Lingual View

Mesio-Distal fit of CrownFacial View Of Crown

Final Crown Cemented . Any Residual Extra Cement is not remained is confirmed in X-Ray

Patient Instruction

Implant Maintaince

Pre-TreatmentPost-Treatment

Thanks For Going Through

Dr Sanjay Bhikaji Sawant