Author
Dr. Young-Ku Heo, DDS, MDS, PhD
Director of Global Academy of Osseointegration
Seoul, Korea
A 65 year old male patient came to the clinic with a periapical lesion on #24. #24 was planned to be replaced with an implant, because it was considered hopeless after a half year of the endodontic treatment.
After 1 months of #24 extraction, flapless implant surgery was performed by tissue punching.
The implant bed was drilled 4-5mm deeper than the fixture height using an initial point drill and a Ø2.2 drill. Its purpose was to place the implant 3mm below the gingival zenith.
A narrow final drill was used to place a Ø4.0X11.5mm implant fixture. Final drilling in an extraction socket is usually performed with an one size narrower drill.
Ø4.0 profile tapping was performed as it was D1 Dense bone. The implant site was tapped 3mm below the gingiva by using a profile tap.
A Ø4.0X11mm IS ll active implant soaked in saline was placed. The implant was placed 3mm below the gingival zenith as placed it up to the 2nd marking on a fixture driver.
The implant was placed 3mm below the gingiva, and 40Ncm of primary stability was obtained.
The surrounding bone could be an obstacle of abutment connection.
Neobiotech Bone Profile was used at 80rpm to trim the surrounding bone. *Bone profile must be used under 80rpm.
The implant site trimmed with a bone profile.
89 of sufficient ISQ value was obtained. The implant was able to avoid compaction and have a good stability through tapping. It was ready to immediately load an implant.
A Ø4.5 Encoded healing abutment was placed on #24. Through intraoral scanning, the length and the diameter of an encoded healing abutment, and the position of its hexagon were able to be recognized.
A scan body pin was placed on the encoded healing abutment for more detailed scanning.
Intraoral scanning using Trios
Side view of the intraoral scan: Intraoral scanner (Trios) enables positioning of an implant and milling of prosthetics on the computer.
The customized abutment was fabricated without using a model.
The final SCRP zirconia crown was delivered a week after the intraoral scanning.
Occlusal view shows the screw hole filled with composite.
Periapical view of the final prostheses
Radiographic panoramic view
In this case, the customized abutment and the final SCRP zirconia crown were fabricated using intraoral scanning system. Through this system, the length and the diameter of an encoded healing abutment, and the position of its hex were able to be recognized without a model.
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