Immediate placement with Class III MI fixation using the SCA technique in the Maxillary 2nd Premolar

Situation

Patient Information

-Patient: A 41-year old male

-Medical history: Smoking, HBP

Diagnosis & Treatment Planning

#15 and #25: Root rest

Immediate placement and Class III sinus bone graft using the SCA kit with simultaneous implant installation was planned on #15

Surgery date: Nov 8, 2016

Pre-operative Panorama

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The root apex is near to the inferior cortical wall of the sinus which is concave.

Intra-oral photograph before extraction

Extracted root rest length was about 10mm. The extraction site was drilled 1 to 2mm deeper than implant length.

2.4mm diameter S-reamer of the SCA kit with 4mm, 5mm, and 7mm stopper were used at the area of #15.

S-reamer was applied for making a hole in the cortical bone at the maxillary sinus floor.

Allograft 0.3cc(RegenOss™) was inserted into the space of the elevated sinus membrane. Bone graft material was applied with the bone carrier of the SCA kit. Bone graft material of the apical side was inserted with the bone condenser from the SCA kit.

Periapical radiograph after bong graft with sinus lifting. Bone material was seen in the sinus elevating the membrane.

After bone graft, trans-mucosal CMI IT-II implant (4.0X10.0) was ready for placement in the area of #15.

Trans-mucosal (non-submerged) type implants was positioned in the middle of the socket. Buccal and lingual space was filled with bone materials after placing the cover cap. The initial torque of the #15 fixture was about 30 Ncm.

2mm height healing abutment was inserted after bone graft. No suture was performed.

Periapical radiograph after implant placement membrane was well-elevated by the bone material around implant apex. The apex of the implant was placed 1-2mm into the sinus.

Click on the image to see clinical video.