Advanced Dental Implant Procedure for Tooth 22 Restoration

Patient Overview

The patient is a 68-year-old male, non-smoker, with no significant medical pathologies. The clinical case presented involved an infection, tooth mobility, and a fracture of tooth 22.

Initial Diagnosis and Treatment Plan

The examination revealed the need for extraction due to the compromised state of tooth 22. The treatment plan focused on an atraumatic extraction followed by implant placement and soft tissue augmentation to achieve an optimal aesthetic and functional outcome.

Procedure Details

1. Atraumatic Extraction and Implant Placement

   • The root of tooth 22 was carefully removed via atraumatic extraction.

   • A surgical flap was opened to provide access for implant placement.

   • A Neodent Z zirconia injected molded implant was selected for its superior aesthetic properties, ideal for the anterior zone.

   • Parallelism was meticulously checked during placement.

2. Bone Augmentation

   • To preserve the contour of the arch, a minor bone augmentation procedure was performed.

   • The surgical site was sutured by first intention, aligning with the insurance constraints, which required the most cost-effective and predictable treatment. This restriction precluded immediate loading of the implant.

3. Cervico Protocol and Soft Tissue Management

   • Using the Cervico system, a template was utilized to select the desired emergence profile.

   • A roll flap technique was performed during the second stage:

     • A U-shaped incision was made.

     • The buccal portion of the flap was de-epithelialized and inverted to enhance soft tissue volume.

   • Implant depth was carefully measured, ensuring a consistent 4mm distance from the shoulder to the soft tissue for optimal integration.

4. Provisional Customization and Healing

   • A VPI-customized healing abutment was created using the implant’s PEEK temporary.

   • The abutment was adjusted and smoothed with composite material, then secured intraorally.

   • Blue M gel, an oxygen-based and oil-free gel, was applied to promote healing throughout the process.

5. Digital Impression and Final Restoration

   • A digital impression was taken once the soft tissue had healed adequately.

   • The final crown was delivered, ensuring precise fit and aesthetic integration.

   • Blue M gel was again used at the connection during crown delivery to support healing and maintain the integrity of the torque.

Outcome

The final restoration showcases excellent integration of the implant and optimal soft tissue healing. Multiple views highlight the aesthetic results achieved through meticulous planning and execution. This case underscores the importance of combining advanced implant systems, precise surgical techniques, and effective post-operative care for predictable outcomes.

Key Takeaways

• Neodent Z implants are highly effective in the anterior aesthetic zone.

• Roll flap techniques significantly enhance buccal soft tissue volume.

• The use of Blue M gel promotes healing and ensures optimal tissue health.

• Adherence to the Cervico protocol ensures accurate emergence profile design and soft tissue management.

This case illustrates the efficacy of a comprehensive approach to implantology, delivering both functional and aesthetic success.