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35 year old male, missing two teeth, but there is only space for one implant. Implant placed at # 12 site, so pontic # 11. Pontic to natural tooth can give a 6-7 mm papilla, while implant to natural tooth will give 5 mm papilla. Implant was set in such a way to not engage the sinus. Grafting to build out the site, not for additional bone to cover then implant.
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Copyright © 2012 Idondivi, Inc. All rights reserved.
Categories ; Posterior, Grafting, Nobel Biocare
2 Copyright © 2012 Idondivi, Inc. All rights reserved
Two teeth, only space for one implant, so cantilever cuspid
3 Copyright © 2012 Idondivi, Inc. All rights reserved
Two teeth, only space for one implant, so cantilever cuspid
4 Copyright © 2012 Idondivi, Inc. All rights reserved
BLP setup for screw retained restoration
5 Copyright © 2012 Idondivi, Inc. All rights reserved
Buccal wing, setup for premolar implant, while not involving sinus
6 Copyright © 2012 Idondivi, Inc. All rights reserved
Guide in place
7 Copyright © 2012 Idondivi, Inc. All rights reserved
X-ray is diagnostic as both BLP’s overlap, no need for rotational correction, so
use green, 0-degree rotation block
8 Copyright © 2012 Idondivi, Inc. All rights reserved
Flapped since buccal will need augmentation to increase volume
9 Copyright © 2012 Idondivi, Inc. All rights reserved
Crest
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Initial osteotomy with drill length set with red flexistop at 10 mm ( 23-10-3)
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Initial osteotomy
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2.8 at 10 mm
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3.4 at 7 mm for stepped back preparation for tapered implant
14 Copyright © 2012 Idondivi, Inc. All rights reserved
Note high tech holder for universal drill guide from Idondivi, Inc.
15 Copyright © 2012 Idondivi, Inc. All rights reserved
Guided tap
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Final osteotomy
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4.3 x 10 mm, Nobel Active
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50 N / cm insertion torque
19 Copyright © 2012 Idondivi, Inc. All rights reserved
Guided, bonemill
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Implant in predetermined position
21 Copyright © 2012 Idondivi, Inc. All rights reserved
Resorbable collagen membrane secured with healingcap
22 Copyright © 2012 Idondivi, Inc. All rights reserved
Bio-Oss, non resorbable grafting material to increase buccal volume
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Covered with resorbable collagen membrane
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# 12 implant with healing cap, ( note that # 7 implant will heal submerged)
25 Copyright © 2012 Idondivi, Inc. All rights reserved
Implant 4.3 x 10 mm Nobel Active placed as planned
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