Early implant placement of the maxillary central incisor to overcome a thin biotype

김용수원장님

Author
Yong Soo Kim, DDS, MSD, CAGS

Private Practice
Yeosu, Korea



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1. There are four different treatment options for post-extraction implant placement.
2. In anterior area, esthetic complication is one of the most common problems especially in thin gingival biotype.
3. Immediate implant placement is not recommend when the anatomical conditions are not ideal.
4. Early placement has been proposed to overcome the esthetic complication in patients at risk.

48 year old female presented to have dental implants on her maxillary anterior tooth and mandibular posterior teeth.

PMH : Non-contributory
No known drug allergy
PDH : Crown on the tooth #21,#26,#44
Root canal therapy on the #21,#26
Missing teeth #37,#45,#46,#47
1. Scaling and root planing
2. Extraction of the tooth #24, 25, 26, 27, 37 and 38
3. Root canal therapy and Crown fabrication of the tooth #36
4. Implant placement of #24,25 and 26 at 2 month after extraction with simultaneous guided bone regener5. ation
6. Uncovering at 4 months after the implant placement
7. Final prosthesis
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Facial view, gingival recession and super eruption on the tooth #21
Thin gingival biotype was observed.


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Pre-op CT Scan

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Extraction of the tooth #21

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#45,46 implant placement

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Neobiotech IS II active implants were placed on the tooth #45,46 (#45: 4.0*10, #46:5.0*10)

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1.5 month of healing after extraction of the tooth #21

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CT scan after soft tissue healing of the tooth #21

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#21 Implant placement

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IS II active 4.0*10 was placed under local anesthesia. Primary stability was achieved. Note buccal dehiscence after implant placement.

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Allogenic bone graft (ICB cortical) was performed and covered with resorbable Collagen membrane.

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Flaps were sutured by 5-0 Nylon

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Uncovering of the tooth #45,46

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Final prosthesis of the tooth #45,46

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Healing after 4 month of #21 implant placement

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Facial bone regeneration was observed.

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Connective tissue graft was inserted on the facial of side of the implant

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Uncovering of the tooth #21

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2 weeks follow up after uncovering of the tooth #21

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3 weeks after uncovering of #21

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Amalgam pigmentation was removed utilizing #15 blade

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Periacryl was applied (no suture)

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Provisional restoration

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Abutment connection

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Final prosthesis, facial gingival recession was restored.

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Final prosthesis, panoramic X-ray

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Final prosthesis, occlusal photo

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Post-op 1.5 year, stable facial gingival margin

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1. Neobiotech implant can be successfully placed and restored in both anterior and posterior area.
2. Early implant placement with simultaneous bone graft can be utilized when anatomical condition is not ideal (thin biotype, recession, chronic infection)
3. Successful outcome was achieved when placed both early and delayed timeframe with Neobiotech IS II active implant
A 48-year-old female presented to have dental implants on her maxillary anterior tooth and mandibular posterior teeth. Neobiotech implant can be successfully placed and restored in both anterior and posterior area. Early implant placement with simultaneous bone graft can be utilized when anatomical condition is not ideal (thin biotype, recession, chronic infection). Successful outcome was achieved when placed both early and delayed timeframe with Neobiotech IS II active implant.

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