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Immediate placement in the mandibular first molar

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Patient information

Patient: 46 years old female Chief complaint: "Dental check-up."

Preoperative observation

#36: - incomplete root canal filling    - radiolucency on the interseptal area and root apex

Treatment planning

Implant site: immediate placement on #36 Surgery date: November 2011 Time for total treatment: 5 months

Occlusal view of the extraction socket 36.

CMI IS-ll active implant was inserted achieving 40Ncm of initial stability, since surrounding bony walls were in in good quality. A large defect was seen around the implant but it was a contained defect.

The peri-implant bone defect was filled with an allogenic bone substitute material (RegenOss) and a healing abutment was connected.

The extraction site was closed with large diameter of healing abutment and sutures.

A month after the surgery.

Peri-implant bone defect was still revealed after a month of implant placement.

Radiograph taken 3 months after implant placement confirmed crestal bone formation around the implant.

5 months after implant placement, a titanium custom abutment was fabricated and connected in the mouth showing a good emergence profile.

A final SCRP zirconia crown was cemented with a final resin cement.

Buccal view of the restoration showing a normal crown contour due to the custom abutment.

8 months postoperative radiograph showed no sign of bone resorption around the implant.

3 years follow-up verified bone crest level maintenance and stability of peri-implant bone.

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