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.


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.



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.


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
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