United Kingdom
CLINICAL CASE
Central incisor with tissue reconstruction with the Nobel Biocare N1™ concept
Dr. Oded Bahat, Dr. Ion Zabalegui,
Dr. Eva Berroeta, Mr. Javier Pérez
Initial clinical situation
Baseline: Ridge atrophy with bone and volume deficiency.
Healed site before the surgery (left).
Large bone and soft tissue defect (right).
Treatment planning
CBCT scan.
Narrow long ridge. Prominent incisal foramen. Buccal concavity. Ridge flared to the facial.
Surgical pre-planning.
Try-in surgical guide (left).
Marking of advanced flap (right).
Surgical procedure
Occlusal view of the narrow ridge (left).
Check of implant position (right).
Check of depth of osteotomy with depth marking on the OsseoDirector™ instrument.
OsseoShaper™ instrument* at low speed (50 rpm) without irrigation (left)
OsseoShaper™ instrument* with bone chips (center).
Osteotomy created by the instrument (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.
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.
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).
Outcome
Radiograph illustrating immediate post-placement position.
Immediate postop radiograph (left).
Immediate postop CBCT illustrating implant position and facial reconstruction (right).
5 days postop (left).
1 year postop facial view (right).
1 year postop occlusal view.
36 months postop.
36 months post-op facial view.
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