"Customized esthetic solution" Immediate implants in immediate function

Introduction

There is a considerable controversy if implants should be placed immediately after extraction of a tooth, especially in the posterior region. Along with that question arise if this implant should be placed with or without a grafting material and if this implant should be loaded with immediate function.

Diagnosis & Treatment plan

A 52 years-of-age female patient presented to the clinic of the school with the first left mandibular molar with an acrylic crown (figs. 1 and 2). Upon probing, a periapical x-ray (fig. 3) and a ct-scan (fig.4) it was possible to detect severe bone loss and the indication for tooth extraction was clear.

Before tooth extraction a bisacrylic provisional restoration was fabricated (figs. 5, 6 and 7) to enhance soft tissue health. After one week, the tooth was extracted (figs. 8 and 9) and a neobiotech IS II active 4,0 x 10,0 mm was placed immediately after extraction (figs. 10 and 11). At the same consult the bisacrylic provisional restoration (fig. 12 and 13) was attached to a titanium temporary component and a screw-retained implant-supported provisional restoration was fabricated (figs. 14, 15, 16 and 17).

After 3-months it is possible to observe the healing of the hard and soft tissues clinically (figs. 18 and 19) and radiographically (fig. 20).

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fig. 1 - pre-operatory occlusion

fig. 2 - pre-operatory buccal and occlusal views

fig. 3 - pre-operatory x-ray

fig. 4 - pre-operatory ct scan

fig. 5 - bisacrylic provisional restoration

fig. 6 - provisional occlusion

fig. 7 - provisional buccal and occlusal views

fig. 8 - tooth extraction

fig. 9 - tooth extraction

fig. 10 - immediate implant placement

fig. 11 - immediate implant placement

fig. 12 - titanium temporary component

fig. 13 - provisional pick-up

fig. 14 - implant provisional restoration

fig. 15 - immediate function

fig. 16 - baseline buccal and oclusal views

fig. 17 - baseline x-ray

fig. 18 - 3-month recall occlusion

fig. 19 - 3-month recall buccal and occlusal views

fig. 20 - 3-month recall x-ray

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Conclusion

The treatment presented is part of a clinical trial using neobiotech IS II active implants immediately after extraction in immediate function. So far 7 implants have been placed and no failures have been observed.