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Molar Protraction & Uprighting

Writer's picture: Dr. Chul Wan ParkDr. Chul Wan Park

Situation


Pre-operative Observation

25 years old male patient presented with missing teeth #17 & 46. #36 was unrestorable as well. #47 was tilted mesially.


Treatment plan Extraction and implant placement on #36 Uprighting of #47 and implant placement on #46 Extraction of #18 and implant placement on #17 with sinus lifting

 

Pre-operative radiograph



Pre-operative intra-oral photograph.


Extraction of #36 was done. Uprighting of #47 was progressing by Miniscrew on retromolar area


CT scan shows severely decreased bone height on #17. Lateral approach for sinus grafting is inevitable for placing implant on that area.

Altered treatment plan: Since lateral approach for sinus grafting on 2nd molar area is technique sensitive, orthodontic protraction of #18 was planned instead of implant placement on #17.

Customized bracket base for passive wire was fabricated.

Customized bracket base for passive wire was fabricated.

Protraction of #18. A Miniscrew was installed between #16 & 15 for anchorage.

Uprighting of #47 was done and implant on #46 was ready to be placed.


Before & After of uprighting of #47

Implant(IS-III, 4.5*10mm) was installed on #46


Panex view after implant placement on #46(IS-III, 4.5*10mm)

Impression taking by PickCap impression coping.


Protraction of #18 was done. Provisional crown on implant #46.

T-loop(017*025 TMA) was activated to upright #47


T-loop(017*025 TMA) was activated to upright #47


Activation of T-loop

Panex view after implant placement on #36(IS-III, 4.5*10mm)


Treatment outcome




Clinical view of final restoration delivered.


Treatment outcome


Post-operative Radiograph

 

Conclusion

A 25-year-old male patient presented with missing teeth #17 & 46. #36 was unrestorable as well. #47 was tilted mesially. Extraction and implant placement on #36, Uprighting of #47 and implant placement on #46 and orthodontic protraction of #18 was planned instead of implant placement on #17.

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