One abutment one time

Copyright © 2012 Idondivi, Inc. All rights reserved.

Categories ; Posterior, Flapless, Grafting, Immediate load, Nobel Biocare

2 Copyright © 2012 Idondivi, Inc. All rights reserved

Preoperative situation


External resorbtion


An overextended impression records a large amount of information.


Drawing of the roots and estimated mesio-distal implant trajectory


Transferring the bone sounding information to the cast. The pinhole indicates the

implant shoulder.


Bucco-lingual setup leaving minimal buccal thickness for the abutment, but

implant in the middle of the bone


Screw retained bucco-lingual, but would give bone fenestration


The best position considering bone and restorative materials


Mesio-Distal position is set


The premolar is removed from a new cast, leaving the outline of the gingival

contours


Model surgery is performed


The cast osteotomy


Working backwards, using the guided implant carrier from Nobel Active


The analog is glued with a composite into the cast


The analog is placed in the same position as the future implant


Permanent zirconia abutment is premade


CAD/CAM zirconia abutment, provisional and coping for final crown are all premade


Screw access of provisional trough buccal


Selected trajectory is good, use green rotation block.


Premolar extracted


Osteotomy created.


Guided bone tap


Final osteotomy


Nobel Active 13 x 4.3


Implant placed as planned


Guided bonemill .


Permanent abutment in place for try-inn.


Provisional in place for try-inn, exactly as planned. No adjustments were made


Provisional is cemented extra orally to prevent cement sepsis


Buccal is grafted with non resorbing bone substitute ( bio-oss)


Permanent abutment with pre-cemented provisional are seated


One abutment, one time


Immediately post extraction and implant placement

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One abutment one time