Immediate Placement of ALX-BT Implants in Mandibular Posterior Extraction Sockets

Case Summary 🔎

Patient Information

• 92y, Female

• Medical history : Hypertension, Hyperlipidemia, Osteoporosis  

Diagnosis

• Chronic periodontitis involving teeth #35 and #36

• Hopeless prognosis of #35 and #36 due to periodontal involvement

• Alveolar bone defect associated with chronic periodontal disease

Treatment Plan

• Atraumatic extraction of #35 and #36

• Immediate implant placement at both extraction sockets

• Fixture placement: ALXBT 5008 at both sites

• Bone grafting

Case Overview

This case involved immediate implant placement in the mandibular posterior region at #35 and #36 following same-day extraction. The teeth were indicated for extraction due to chronic periodontitis. After the initial drilling, bone density was assessed intra-operatively and identified as D333. A minimally invasive drilling protocol was performed using the ALX Kit. ALX-BT 5008 fixtures were placed at both sites, achieving initial torque values ranging from 70 to 40 Ncm and an IST value of 88. Bone grafting was performed using Neoss-B xenograft and autogenous bone to manage the defect areas. At 5 weeks postoperatively, final cementless zirconia prostheses were delivered, demonstrating an efficient treatment workflow from immediate placement to final restoration.

Case Presentation

1️⃣Pre-op

• Teeth #35 and #36 presented with chronic periodontitis and were considered to have a hopeless prognosis, requiring extraction.

• Immediate implant placement was planned based on the preservation of the buccal and lingual socket walls.

2️⃣ Surgery

• Sequential drilling was performed from Ø2.5 × 10 mm to Ø4.5 × 10 mm.

• Alveoloplasty was performed to recontour the sharp bony ridge.

• Bone density was assessed after the initial drilling and identified as D333.

• Osteotomy direction and depth were radiographically verified.
  

• ALX-BT 5008 fixtures were placed at both extraction sites.

• Initial torque was adjusted from 70 to 40 Ncm.

• Healing abutments were connected to the placed fixtures.

• Extraction socket defects were grafted using Neoss-B xenograft and autogenous bone. The graft material was adapted to support defect fill.

• The flap was repositioned and sutured to achieve soft tissue closure around the healing abutments.

• Postoperative periapical radiograph

3️⃣Prosthesis

• Intraoral scanning was performed 3 weeks after surgery.

• At 5 weeks postoperatively, final cementless zirconia prostheses were delivered with an IST value of 78 recorded before restoration.

• Panoramic radiograph after final prosthetic delivery

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