Immediate placement and 1-week loading of 7 mm wide ALX-IT implant in compromised molar site

GAO
Oct 22, 2025
2 min read

Updated: Nov 4, 2025

Case Summary 🔎

Introduction

Immediate placement of a 7mm diameter ALX-IT implant in a compromised mandibular molar site

A mandibular right first molar (#36) with chronic periodontitis and a deep pocket was extracted. The septum bone was flattened using the IP (Immediate Placement) drill from the VaroGuide kit, followed by final drilling with a Ø5mm drill. A Ø7mm diameter ALX-IT implant (27008) was placed, featuring a 5mm core and 1mm deep threads, enabling stable fixation even with limited buccal and lingual bone contact.

Primary stability was confirmed with a final insertion torque of 50 Ncm and an ISTV of 80. Immediate loading was planned, and an intraoral scan was taken. After one week, the ISTV had increased to 84, and a zirconia prosthesis (CL-Link type) was delivered

Case Presentation

1️⃣ Pre-Op

Pre-operative panoramic radiograph

2️⃣ Surgery

The mandibular right first molar (#36), presenting with a deep periodontal pocket due to chronic periodontitis, was extracted.
The septum bone was flattened using an IP (Immediate Placement) drill.
Drilling was performed to a depth of 10 mm using a Ø5 mm drill, followed by placement of a Ø7.0 × 8 mm ALX-IT implant.
Primary stability was achieved with an insertion torque of 50 Ncm, indicating suitability for immediate loading
Primary stability was achieved with an insertion torque of 50 Ncm, indicating suitability for immediate loading
The surrounding gap was filled with allograft (NeoBone), and immediately after placement.
The mobility of the implant was measured using AnyCheck, yielding an ISTV value of 80.
Considering the stability value, immediate loading was deemed possible even with minor gaps around the implant.
On the same day, a healing abutment-type scan body was connected to acquire intraoral scan data.

3️⃣ Post-Op

Post-operative panoramic radiograph

4️⃣ Final restoration

1 week later, the healing status of the gingiva was evaluated, and an ISTV value of 84 was recorded. This represented an increase of 4 points compared to the day of surgery.
A zirconia prosthesis fabricated in the CL-Link (Cementless-Link) type was installed and tightened with a torque of 30 Ncm.
The final occlusion was carefully adjusted so that the shimstock held when biting firmly, and slipped out naturally when the patient closed lightly.
Post-prosthetic panoramic radiograph