Immediate placement on #36 using VARO Guide

*Click on the picture to enlarge.

허영구 원장님 Dr. Heo

Author
Dr. Young-Ku Heo, DDS, MSD, Ph.D

Director of Global Academy of Osseointegration
Seoul, Korea



[Patient information]
- 69 years old, Male
- PMH: Non-contributory
- No known drug allergy
- C.C: "I feel sharp pain whenever I bite something."
- Diagnosis: Cracked tooth(mesial root)


[Treatment Plan]
1. Extraction of the tooth #36
2. Immediate implant placement with simultaneous bone grafting at the gap between the implant and the extraction socket
3. Delivery of final restoration after 3 months
4. Periodical follow-up
[Pre-operative observation]
Clinical view and periapical radiograph of #36 with a mesial root fracture indicated by a red arrow.
IMG_1562
Prior to the extraction of #36, indexing(or impression) of the surgery area is performed with a Pre-Guide(PGS13).

IMG_1563
Atraumatic extraction of #36 to preserve the septum and thorough irrigation of the socket with saline.

그림1
The osteotomy is done 1 to 2mm deeper than the extraction socket so that good initial stability can be achieved.

11
Plasma surface treatment on imlant can be obtained with Osteo Active Unit, which siginificantly increases hydrophilicity of implant surface.

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Implant (IT-III Wide Ø5.0x11.5mm, Neobiotech) was placed more mesially on purpose based on prosthetic considerations. Bone graft material was filled at the gap between extraction socket and implant.

2
A wide-diameter healing abutment is connected to seal the extraction socket. The use of wide healing abutments prevents the loss of bone graft without suturing.

고호성_1
Panoramic radiograph shows the path and the position of the implant are ideal.

IMG_1683
2 weeks post-up, soft tissue healing around the implant is almost complete.

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Panoramic radiograph following the delivery of final prosthesis.

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6months post-op, Gingival architecture around #36 appears to be natural.

20191016_2
Periapical radiograph 6 months following the delivery of the final restoration. Note that peri-implant bone remains at its original level.

8 months post-op, No clinical change is noticed.

고호성_20200615 (Pano)
Panoramic view 8 months post-op, No bone loss was observed around #36.

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