United Kingdom
CLINICAL CASE
Buccal bone augmentation during immediate implant placement
Dr. Bastian Wessing
Patient: 24-year-old female.
Clinical situation: Hopeless tooth 11 after traumatic accident with discoloring, persistent pain and mobility grade II.
Surgical solution: Immediate implant placement with gap augmentation using creos™ xenogain (small granules).
Restorative solution: Immediate provisional restoration.
Final restoration: NobelProcera® ASC Abutment with veneered zirconia.
Surgery date: May and August 2016 Total treatment time: 3 months.
Initial clinical situation
Pre-operative situation: single X-ray after three months of endodontic treatment after trauma (left).
In the facial view, tooth 11 (FDI) appears discolored with persistent pain and mobility grade II (Miller) (right).
Surgical procedure
Extraction of hopeless tooth 11 (FDI), with intact buccal bone (left).
Pilot-drill with a lab side drilling guide and extension drill into the alveolar-palatal bone (right).
Immediate implant placement using a NobelActive® 4.3 × 13 mm implant (left).
Optimized implant placement: slightly palatal without compression or even contact with the buccal bone (right).
Augmentation of the buccal gap with creos™ xenogain (small granules) to reduce bucco-palatal resorption of the alveolar ridge volume (left).
Occlusal view after gap augmentation (right).
Panoramic radiograph after implant placement.
Screw-retained provisional titanium abutment after opaque application (left).
Facial view of a chairside provisional for immediate restoration (right).
Occlusal view of the emergence profile after two months healing time (left).
Impression with an impression coping in an open-tray technique (right).
Veneered zirconia NobelProcera® ASC Abutment for a screw-retained single implant crown (left).
Side view of the finalized NobelProcera® ASC Abutment with the Omnigrip™ screwdriver on the master cast (right).
Outcome
Occlusal view of the final restoration after three months' treatment time. Note the slight bucco-palatal resorption of the alveolar ridge (left).
Facial view of the final restoration (right).
Facial view of the final restoration.
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