Nobel Biocare N1™ system with immediate loading
Dr. Alfonso Caballero de Rodas
Spain
Nobel Biocare N1™ Implant with immediate placement in a fresh extraction socket. Atraumatic tooth extraction with immediate implant in a palatal position, then immediate loading using a temporary abutment screwed to the implant.
Patient: 46 years old, female, no significant diseases
Clinical situation: broken tooth #15. The fracture is subcrestal, and the tooth cannot be restored
Surgical solution: tooth extraction and immediate implant placement with immediate loading
Restorative solution: screw-retained temporary acrylic crown, directly connected to the implant
Surgery date: October 5th, 2020
Tooth position: #15
Initial clinical situation
Situation before the surgery with a visible fracture of tooth #15 (left).
Radiographic image at presentation showing crown fracture on tooth #15 (right).
Treatment planning
CBCT maxilla. Good bone foundation in 3 dimensions. No infections.
Treatment planning
Digital treatment planning in DTX Studio™ Implant – 13 mm implant and temporary abutment.
Treatment planning
DTX Studio™ Implant report:
Nobel Biocare N1™ TiUltra™ TCC RP 4 x 13 mm
Temporary Abutment Nobel Biocare N1™ TCC RP 1.5 mm.
Surgical procedure
Atraumatic tooth extraction.
Surgical procedure
Verification of the extraction socket depth – confirmed 15 mm, sufficient to place the 13 mm implant.
Surgical procedure
First step in site preparation: The OsseoDirector™ instrument defines final implant position (left).
Second step: The OsseoShaper™ instrument operates at low speed 50 rpm and without irrigation. It creates a specific osteotomy for the co-packed Nobel Biocare N1™ Implant (right).
Surgical procedure
View of the OsseoShaper™ instrument freshly removed from the site (left).
Nobel Biocare N1™ Implant featuring the TiUltra™ surface (right).
Surgical procedure
Nobel Biocare N1™ Implant placement (left).
Nobel Biocare N1™ Implant insertion (right).
Surgical procedure
The Nobel Biocare N1™ Implant being placed in a fresh extraction socket (left).
Occlusal view of the final implant position – flat side of the trioval conical connection (TCC) oriented towards buccal (right).
Restorative procedure
Temporary Abutment TCC 1.5 mm connected directly to the implant (left).
Temporary Abutment post reduced to the required height (right).
Restorative procedure
Provisional restoration in place after occlusal clearance check (left).
X-ray of the implant with the provisional restoration at the day of surgery (right).
Outcome
Lateral view 2 weeks post surgery. Tissue margin is stable (left).
Tissue healing. We can see how transeptal fibers are healed and stable (right).
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