7-month result of Immediate Placement using a precision Neo NaviGuide and Immediate Loading

Situation

A 71-year-old male

Non-smoker

Pre-operative Panorama

Intra-oral photograph.

Root rests were extracted atraumatically.

Extraction socket.

A precision Neo NaviGuide was fabricated.

Checked the Neo NaviGuide in the mouth.

A point drill was used for initial drilling.

One-step undersized drilling was performed in each side.

IS-II active 4.5x13mm was placed in the extraction socket of #35.

IS-II active 5.0x13mm was placed in the extraction socket of #36. The precision guide allowed exact placement of the implant as planned.

35Ncm initial insertion torque was obtained each side. The hex position coincided with the sleeve line.

Both implants were placed in the right position.

Because the implant (#36) was engaged in the buccal lingual septal bone, spaces remained around the coronal part of the implant.

However, immediate loading was decided due to sufficient primary stability.

A definitive 2-unit zirconia SCRP FPD were fabricated on the SCRP abutments (semi-hex) in advance.

The SCRP abutments were repositioned.

After positioning cover screws, bone graft was performed.

2-unit SCRP zirconia FPD was cemented with a final resin cement. The FPD was then removed by unscrewing the screws through the screw hole, and the excess cement was polished outside. The crown margin was well seated as shown.

The prosthesis was repositioned and the screw holes were occluded by resin.

The gingival margin was well adapted to the crown contour.

July 18, 2016 Day of implant placement and loading. A panoramic radiograph after the final delivery of the prosthesis on the same day of surgery.

July 18, 2016 Periapical x-ray at the day of surgery. The crown margins were a bit opened.

7-months follow-up radiograph. No bone loss and no clinical symptom were observed.

Click on the image to see clinical video.