Lower molar early implant placement.
This case highlights all the new concepts and developments in redesigning the peri-implant soft tissues following simplified contemporary protocols.
Customised healing abutments can help us manage the emergence profile without the need for complicated and extensive surgeries, which is the key to excellent implant work, that complies with all functional, aesthetic and biological requirements.
Initial and final situation.
The initial situation, 4weeks after the extraction of the lower left first molar.
A 9 mm cylindrical tab was used to evaluate intraorally the edentulous area before the surgery. Using the appropriate cylindrical tab the prosthetic space was accurately measured. This tab was used also as a surgical stent to guide the initial trephination.
Initial pilot trephination completed and a pin was placed to check the position and direction.
Full-thickness flap raised and a 5.0x8.0 implant was placed achieving high initial stability.
Using the Cervico calliper the depth of the implant placement and the thickness of the overlying soft tissues were measured.
In this case, the implant was placed 1 mm sub-crestally to allow adequate space for all anatomical components of the future implant transmucosal complex.
The customised Cervico healing abutment was fabricated using the Cervico Essential mold.
Grafting with synthetic b-TCP/calcium sulfate before fitting the customised healing abutment.
Fitting of the abutments and suturing with 5-0 monofilament SKD sutures.
From this moment on the transmucosal complex starts being formed, in parallel to the osseointegration of the implant and the regeneration of the hard tissue.
Bluem oxygen-releasing gel for disinfection and for the enhancement of soft tissue healing.
Simplified contemporary approach to redesign the peri-implant soft tissues, without the need for soft tissue grafting.
Now that we have created the correct emergence profile, we can transfer all the information to the lab, to create the restoration that complies with all functional, biological, and aesthetic requirements.
Exceptional work by Phill Reddington at Beever Dental Laboratory.
The prosthetic canal was sealed with SilverPlug to reduce the bacteria at the implant-abutment interface.
This is especially important for implants with internal hex connections.
Initial situation and final result.