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Dr. Alfonso Caballero de Rodas

Nobel Biocare N1™ system with immediate loading

Dr. Alfonso Caballero de Rodas

Spain

Case courtesy of Dr. Caballero

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

 

 

 

Case courtesy of Dr. Alfonso Caballero de Rodas.

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Case courtesy of Dr. Caballero

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).

Case courtesy of Dr. Caballero

Treatment planning

CBCT maxilla. Good bone foundation in 3 dimensions. No infections.

Case courtesy of Dr. Caballero

Treatment planning

Digital treatment planning in DTX Studio™ Implant – 13 mm implant and temporary abutment.

Case courtesy of Dr. Caballero

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.

Case courtesy of Dr. Caballero

Surgical procedure

Atraumatic tooth extraction.

Case courtesy of Dr. Caballero

Surgical procedure

Verification of the extraction socket depth – confirmed 15 mm, sufficient to place the 13 mm implant.

Case courtesy of Dr. Caballero

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).

Case courtesy of Dr. Caballero

Surgical procedure

View of the OsseoShaper™ instrument freshly removed from the site (left).

Nobel Biocare N1™ Implant featuring the TiUltra™ surface (right).

Case courtesy of Dr. Caballero

Surgical procedure

Nobel Biocare N1™ Implant placement (left).

Nobel Biocare N1™ Implant insertion (right).

Case courtesy of Dr. Caballero

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).

Case courtesy of Dr. Caballero

Restorative procedure

Temporary Abutment TCC 1.5 mm connected directly to the implant (left).

Temporary Abutment post reduced to the required height (right).

Case courtesy of Dr. Caballero

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).

Case courtesy of Dr. Caballero

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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