Immediate loading in the maxillary anterior region using VARO Guide

허영구 원장님 Dr. Heo

Author
Dr. Young-Ku Heo, DDS, MDS, PhD

Director of Global Academy of Osseointegration
Seoul, Korea



Patient information: 48 years old, Female
Treatment plan:
1. Hard & soft tissue augmentation on the labial side of #11
2. Implant placement using VARO Guide and immediate loading
In the Pre-OP clinical pictures and panoramic view, there is labial gingival deficiency on #11.
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Lingual incision was made and thick soft tissue from palatal area was rolled to augment the soft tissue.

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Labial bone deficiency was observed.

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An impression was made with a Pre-Guide, in which a light-curing resin and impression material was filled, then was light-cured in the mouth and removed. Then CBCT was taken with the Pre-Guide in the mouth.

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The Pre-Guide library was merged in the CT image.

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Implant positioning was performed in the program(VARO Plan). Labial bone was very thin and needed bone graft.

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Drilling was performed with point drill through the VARO Guide hole.

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Drilling was performed with 2.2 initial drill through the VARO Guide hole.

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The final drill for a ф4.0x10mm IS-III fixture was used through the hole with 1,200rpm.

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The short cortical tap was used for pre-tapping in the coronal cortical bone for passive maximum contact between the cortical bone and implant for immediate loading.

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IS-III Active ф4.0x10mm was placed. The initial torque was 40N/cm that allowed Anytime loading. The fixture was placed in the same position as planned.

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A temporary abutment for immediate loading(facial view)

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Periapical radiograph shows proper direction of implant.

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Bone graft was performed using DM bone.

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A temporary crown was made on the abutment and bone graft was done.

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Suture was done with the restoration.

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S/O after 2 weeks of implant placement

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Final prosthesis was delivered after 1 month. (Facial view)

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Final prosthesis was delivered after 1 month. (Periapical radiograph)

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F/U after 1.5 month, #11 maintains a convex contour at labial aspect without loss of papilla.

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Periapical radiograph after 1.5 month

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