Skip to main content
Dr Fabrizio Colombo

Immediate loading of post extractive single tooth in esthetic zone with simultaneous GBR

Dr. Fabrizio Colombo, DDS

Milan, Italy

Case courtesy of Dr. Colombo

Patient: 69 years old, male, no systemic diseases, no oral pathology or dental problems.

Clinical situation: presence of a damaged upper left first premolar.

Surgical solution: extraction of 24, simultaneous placement of a NobelReplace PMC 4.3x11.5 and filling of the buccal gap using creos™ xenogain.

Restorative solution: Provisional: immediate loading using a screwed acrylic crown (temporary abutment engaging). Final: screwed zirconia crown.

Surgery date: November 22, 2018.

Total treatment time: 7 months.

Tooth position: upper left first premolar.

 

 

 

Case courtesy of Dr. Fabrizio Colombo, DDS.

Some products may not be regulatory cleared/released for sale in all markets.

Please use landscape mode when viewing this page on mobile.

Case courtesy of Dr. Colombo

Initial clinical situation

Front view (left) and Buccal view (right).

Case courtesy of Dr. Colombo

Initial clinical situation

Detail of the typical buccal convex architecture in the area of 24. Frontal view (left).

Detail of the typical buccal convex architecture in the area of 24. Occlusal view (center).

Pre-operative X-ray (right).

Case courtesy of Dr. Colombo

Surgical procedure

Loss of the palatal wall of the crown on 24 (left).

Vertical fracture on 24 (right).

Case courtesy of Dr. Colombo

Surgical procedure

Detail of 24 after extraction; presence of two vestibular roots and an accidental fracture of the buccal bone plate (left).

Leveling and cleaning of the buccal wall (right).

Case courtesy of Dr. Colombo

Surgical procedure

Detail of the implant site preparation in the alveolus palatal region. The interradicular septum has become the new buccal cortical bone around the implant (left).

NobelReplace® PMC 4.3 x 11.5 mm insertion (35 N/cm) (right).

Case courtesy of Dr. Colombo

Surgical procedure

Occlusal detail of the implant placement (left).

The socket is filled using creos™ xenogain 0,5 g small granules (right).

Case courtesy of Dr. Colombo

Surgical procedure

Insertion of the graft in the buccal socket (left).

View of the biomaterial placed (center).

Temporary protection of the graft with fibrin sponge (right).

Case courtesy of Dr. Colombo

Surgical procedure

Impression phase (left)

X-ray taken during the impression phase (right).

Case courtesy of Dr. Colombo

Restorative procedure

Detail of the impression (Impregum 3M ESPE) (left).

Temporary screwed crown a few days after surgical phase (center). 

Temporary crown X-ray (right).

Case courtesy of Dr. Colombo

Outcome

Final clinical situation of the gingival tunnel (occlusal view). Detail of the buccal convex architecture (7 months after implant placement) (left).

Final zirconia screwed crown (occlusal view) (right). 

Case courtesy of Dr. Colombo

Outcome

Final ceramic screwed crown (lateral view, 7 months after implant placement) (left).

Final ceramic screwed crown (frontal view). Detail of the buccal convex architecture (7 months after implant placement) (right).

Case courtesy of Dr. Colombo

Outcome

CBCT 7 months after the implant placement.

Related products

Resources

Sign up for our blog update

Get the latest clinical cases, industry news, product information and more.

© Nobel Biocare Services AG, 2021. All rights reserved. Distributed by: Nobel Biocare. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. All product images are for illustration purposes only and may not be an exact representation of the product. Please contact the local Nobel Biocare sales office for current product assortment and availability. Disclaimer: For prescription use only. Caution: Federal (United States) law or the law in your jurisdiction may restrict this device to sale by or on the order of a licensed clinician, medical professional or physician. See Instructions For Use for full prescribing information, including indications, contraindications, warnings and precautions. OCS-B (Nibec Co., Ltd.) is distributed as creos™ xenogain since September 2016. Legal Manufacturer: Nibec Co., Ltd. Iwol electricity-electronic Agro-industrial Complex, 116 Bamdi-gil, Iwol-myeon, Jincheon-gun, Chungcheongbuk-do, 27816 Korea. Nobel Biocare does not take any liability for any injury or damage to any person or property arising from the use of this clinical case. This clinical case is not intended to recommend any measures, techniques, procedures or products, or give advice, and is not a substitute for medical training or your own clinical judgement as a healthcare professional. Viewers should never disregard professional medical advice or delay seeking medical treatment because of something they have seen in this clinical case. Full procedure is not shown. Certain sequences have been cut.