Dr. Giacomo Fabbri

Immediate implant placement and immediate implant loading with NobelActive® TiUltra™ implant and On1™ Base Xeal™

Dr. Giacomo Fabbri



Case courtesy of Dr. Fabbri

Patient: 51-year-old female, smoker. The patient is in good health condition. Smokes eight cigarettes per day.

Clinical situation: The clinical intraoral situation is adequate except for 25, which is non-vital, fractured, presents caries, has endodontic lesion and the tooth position is not optimal for correct restoration. The tooth is severely compromised biomechanically.

Surgical solution: Extraction of tooth 25 with immediate implant placement and immediate loading.

Restorative solution: NobelProcera Monolithic Zi Crown cemented extraorally on the Universal Abutment (0.3 mm). The final restoration will be screw-retained.

Surgery date: April 9, 2019

Total treatment time: 2 months

Tooth position: 25




Case courtesy of Dr. Giacomo Fabbri.

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Initial clinical situation

Case courtesy of Dr. Fabbri

X-ray shows the residual root (left).

Pre-operative clinical view shows good soft tissue quality and quantity (center).

The occlusal view demonstrates the loss of structure of the clinical crown (right).

Surgical procedure

Case courtesy of Dr. Fabbri

Tooth 25 was extracted while maintaining the integrity of the bone walls (left).

NobelActive® TiUltra™ RP 4.3x13mm was placed immediately with flapless approach. The primary stability of 56 Ncm was achieved. Implant was placed slightly palatally. The buccal gap was filled with creos™ xenogain (center).

On1™ Base Xeal RP 1.75 mm was placed immediately on the day of the surgery and torqued to 35 Ncm (right).

Surgical procedure

Case courtesy of Dr. Fabbri

10-week follow-up after the surgery: Clinical and radiographic evaluation shows excellent bone and soft tissue integration.

Restorative procedure

Case courtesy of Dr. Fabbri

Impression taking.

Working on a new coronal prosthetic platform avoids compromising soft tissue healing and stability.
This photo shows the excellent soft tissue quality achieved 10 weeks after the surgery.

Restorative procedure

Case courtesy of Dr. Fabbri

Final restoration: NobelProcera Monolithic Zirconia Crown cemented on the Universal Abutment (0.3 mm).

Excellent esthetics of the final restorative outcome. A healthy and natural appearance of soft tissue morphology was obtained around the restoration (left, center).

X-ray demonstrates the excellent bone stability (right).


Case courtesy of Dr. Fabbri

1-year follow-up: Restoration is fully integrated, and a significant improvement in soft tissue integration and esthetics was achieved.

Intraoral photograph shows the soft tissue gain obtained in the interproximal area (left, center).

X-ray confirms the successful osseointegration and marginal bone stability after 1 year of function (right).

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