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Dr. Bahat, Dr. Zabalegui, Dr. Berroeta, Mr. Pérez

Central incisor with tissue reconstruction with the Nobel Biocare N1™ concept

Dr. Oded BahatDr. Ion Zabalegui, Dr. Eva Berroeta, Mr. Javier Pérez

Spain

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Implant placement in the anterior zone with ridge augmentation.

Patient: 38 years, female

Clinical situation: healed site in esthetic zone. Compromised ridge vertically and horizontally

Surgical solution: implant placement with GBR

Restorative solution: single implant supported restoration

Surgery date: Bilbao, April 27, 2019

Total treatment time: 1 year 2 months

Tooth position: 11 (FDI), 8 USA    

 

 

 

Patient treatment courtesy of Dr. Oded Bahat, Dr. Ion Zabalegui, Dr. Eva Berroeta, Mr. Javier Pérez.

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Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Initial clinical solution

Baseline: Ridge atrophy with bone and volume deficiency. 

Healed site before the surgery (left).

Large bone and soft tissue defect (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Treatment planning

CBCT scan.
Narrow long ridge. Prominent incisal foramen. Buccal concavity. Ridge flared to the facial.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Treatment planning

Surgical pre-planning.

Try-in surgical guide (left).

Marking of advanced flap (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Occlusal view of the narrow ridge (left).

Check of implant position (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Check of depth of osteotomy with depth marking on the OsseoDirector™ instrument.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

OsseoShaper™ instrument* at low speed (50 rpm) without irrigation (left)

OsseoShaper™ instrument* with bone chips (center).

Osteotomy created by the instrumenon (right).

* In this clinical case the pre-launch version of the OsseoShaper™ instrument has been used: the “CS Soft Bone Gizmo”. Black markings on the shaft and a 0.5 mm longer tip on the instrument are introduced on the final design of the OsseoShaper™ instrument.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Implant* of the Nobel Biocare N1™ concept is placed at osteotomy (left).

Implant insertion torque to 55 Ncm (center).

Occlusal view of implant in place (right).

* In this clinical case the pre-launch version of the Nobel Biocare N1™ implant has been used: the “CS Tiger Ultra Implant”. A flat platform is introduced on the final design of the Nobel Biocare N1™ implant.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Surgical procedure

Reconstructed hard tissue site with bone augmentation and L-PRF.

Fenestration and fracture of buccal plate (left).

Allograft and autogenous bone graft placed (center).

Placement of L-PRF membrane (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Outcome

Radiograph illustrating immediate post-placement position.               

Immediate post-op radiograph (left).

Immediate post-op CBCT illustrating implant position and facial reconstruction (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Outcome

5 days post-op (left).

1 year post-op facial view (right).

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Outcome

1 year post-op occlusal view.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Outcome

36 months post-op.

Case courtesy of Dr. Bahat, Dr. Zabalegui, Dr.Berroeta and Mr. Pérez

Outcome

36 months post-op facial view.

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