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Initial situation with 45 fractured just before its extraction
Insertion of the 3.5 mm diameter Neobiotech IS-II implant by means of guided surgery to be sure to insert the implant in correct 3D position, and to avoid any injury to the adjacent roots
As soon as the implant is inserted, the thickness and height of the soft tissues are checked. If the vertical dimension is at least 3mm, then no soft tissue graft is required.
It can be seen that during the extraction maneuvers of the tooth, the fracture of the ceramic crown was caused on 46.
A temporary abutment of the thinnest possible size is screwed in, notches are created in it to increase the retentive effect and some Teflon is packed inside to prevent resin from entering during the relining of the provisional crown
Immediately prior to relining, the provisional with positioning tabs is tested to ensure that it fits correctly
Once the provisional relining is complete, a healing screw is screwed in and the primary stability of the implant is measured with AnyCheck. The IST value was 68 with a 6mm high healing screw, and then the stability of the implant was ideal to procede with an immediate provisionalization.
The gap between the implant and the buccal bone plate was filled with heterologous biomaterial to better maintain the buccal bone.
The biomaterial is inserted up to the gingival margin to give support also to the soft tissues.
The provisional crown at the end of its finishing and polishing
At the end of the surgery the provisional crown was screwed and its height was reduced to remove it from both static and dynamic occlusal contacts.
A collagen sponge was inserted between the crown and the gingival margin to protect the biomaterial.
10 days after surgery, the soft tissues already show ideal healing
Initial radiograph showing the curvature of the root which would have made freehand implant insertion difficult.
Final X-ray testifying the correct implant insertion in the3D positions of the space and the correct screwing of the temporary abutment.