Ext. & immediate implantation (TS III SA) using OneGuide GBR with A-Oss, SureOss & OssGuide
– Immediate provisional restoration with OneFit
By Chang Ho Choi
Introduction
The case highlights an advanced approach for addressing crown-root fractures at tooth numbers #12 and #22 through immediate extraction and implantation using the OneGuide system. This method is complemented by guided bone regeneration (GBR) with A-Oss, SureOss, and OssGuide bone materials, and concludes with the immediate provisional restoration facilitated by OneFit system. The effectiveness of these techniques is evidenced by the stability and quality of the resulting bone structure, ensuring both functional and aesthetic restoration.
Patient Information
- Age / Sex : 44 / Female
- Tooth Number: #12=#22 4-unit br.
- CC : Tooth fx.
- Dx : Cr.-root fx. #12, #22
Treatment Plan
- Extraction of #12, 22 & immediate implantation on #12, 21 using OneGuide
- GBR with A-Oss, SureOss and OssGuide
- Immediate provisional restoration with ready made OneFit & PMMA bridge
Clinical Procedures
- Operation Planning on #12, 21: Detailed preoperative planning involves assessing the patient’s dental anatomy and determining the precise placement for implants #12 and #21 using the OneGuide system. This step ensures a tailored surgical approach and optimal outcomes.
- Extraction and OneGuide Try-On: Teeth #12 and #21 are carefully extracted. The OneGuide surgical guide is then tried on to ensure accurate fit and positioning for subsequent implantation.
- Flap Open (Labial Bone Defect): A flap is opened to expose the underlying bone structure, revealing a labial bone defect that requires attention during the GBR process.
- Implantation (TS III SA) on #12, 21: Implants (TS III SA) are placed at sites #12 and #21 using the OneGuide system. The exposed fixtures include the apex of #12 and the platform of #21, which are critical for achieving initial stability and integration.
- GBR with A-Oss, SureOss, and OssGuide: Guided Bone Regeneration procedure is performed using a combination of A-Oss, SureOss, and OssGuide materials. These bone materials are strategically placed to enhance bone quality and quantity around the implants, followed by the use of Vicryl sutures for securing the graft.
- Connecting OneFit: The OneFit system is connected to the implants, facilitating the immediate provisional restoration process.
- Suture: Surgical sutures are placed to secure the flap and ensure proper healing of the surgical site.
- Provisional Restoration: A provisional restoration is placed immediately, utilizing pre-made OneFit components and a PMMA bridge, ensuring aesthetic and functional provisionalization during the healing phase.
- Post-Implantation and GBR Evaluation on #12, 21: The implant sites are evaluated after the GBR procedure to ensure stability and proper integration of the bone graft materials.
- Placing Customized Abutments (Labial and Incisal): Customized abutments are placed both labially and incisally to prepare for the final prosthodontic restoration.
- Delivery of Prosthodontics (PFZ): The final prosthodontic restoration, a porcelain-fused-to-zirconia (PFZ) bridge, is delivered, ensuring a durable and aesthetically pleasing outcome.
Conclusion
- -root fx. #12, 22
- OneGuide is very easy and precise
- Also use ready made OneFit & provisional br. For immediate restoration
- TS III SA is easy to acquire initial stability
- A-Oss, SureOss, OssGuide make clinically enough quantity and quality bone
