Immediate placement in the mandibular first molar

허영구 원장님 Dr. Heo

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

Director of Global Academy of Osseointegration
Seoul, Korea



Patient: 46 years old female
Chief complaint: "Dental check-up."
#36: - incomplete root canal filling
   - radiolucency on the interseptal area and root apex
Implant site: immediate placement on #36
Surgery date: November 2011
Time for total treatment: 5 months
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Occlusal view of the extraction socket 36.

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CMI IS-ll active implant was inserted achieving 40Ncm of initial stability, since surrounding bony walls were in in good quality. A large defect was seen around the implant but it was a contained defect.

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The peri-implant bone defect was filled with an allogenic bone substitute material (RegenOss) and a healing abutment was connected.

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The extraction site was closed with large diameter of healing abutment and sutures.

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A month after the surgery.

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Peri-implant bone defect was still revealed after a month of implant placement.

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Radiograph taken 3 months after implant placement confirmed crestal bone formation around the implant.

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5 months after implant placement, a titanium custom abutment was fabricated and connected in the mouth showing a good emergence profile.

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A final SCRP zirconia crown was cemented with a final resin cement.

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Buccal view of the restoration showing a normal crown contour due to the custom abutment.

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8 months postoperative radiograph showed no sign of bone resorption around the implant.

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3 years follow-up verified bone crest level maintenance and stability of peri-implant bone.

This case shows immediate placement in the posterior mandible followed by tooth extraction using cortical and cancellous allograft (RegenOss).

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