Immediate Implant placement (TS III) using Oneguide and Provisional Restoration in the esthetic zone (#22)
By: Heejun Yoon
Introduction:
Immediate implant placement in the esthetic zone offers significant benefits, such as reduced treatment time and preserved alveolar bone. This case study examines the use of the TS III implant and OneGuide system in an 80-year-old female patient with a fractured root at tooth #22. The procedure involved atraumatic extraction using a periotome, followed by immediate implantation and provisional restoration. The TS III implant’s advanced design and OneGuide’s precise digital planning ensure stability and optimal esthetic results, providing a promising solution for immediate restoration in the anterior maxillary region.
Patient Information
- Age / Sex : 80 / Female
- Tooth Number : #22
- CC : Tooth fractured and root rest state on Lt. maxillary anterior area
- PI: Root rest state
- Dx : Root rest of #22 with horizontal root fracture
Treatment Plan
- Extraction of #22
- Immediate Implantation on #22 using OneGuide & Immediate provisional restoration
Clinical Procedures
- Planning with CBCT Radiograph Image: A Cone Beam Computed Tomography (CBCT) scan was performed to obtain a detailed 3D image of the patient’s maxillary anterior region, particularly focusing on tooth #22. This imaging provided essential information on the bone structure and density, crucial for planning the implant placement.
- OneGuide with Diagnostic Model: A diagnostic model was created using the CBCT data, allowing for precise planning and simulation of the implant placement. The OneGuide system, a digital surgical guide, was put on this model to ensure accurate and minimally invasive implantation.
- Atraumatic Extraction Using Periotome: Tooth #22, which had a horizontal root fracture, was carefully extracted using a periotome. This instrument facilitated atraumatic extraction, preserving the surrounding alveolar bone and soft tissue, which is critical for immediate implantation.
- OneGuide for Placing Implants on #22: The OneGuide system was employed to guide the precise placement of the implant. The guide ensured the optimal angulation, depth, and position of the implant, aligning with the preoperative plan.
- Implant Placement on #22 Using OneGuide: The TS III implant was inserted into the prepared socket using the OneGuide. The implant’s advanced design provided immediate primary stability, essential for the success of immediate implantation.
- Temporary Abutment: A temporary abutment was attached to the implant, providing a foundation for the provisional crown. This abutment is designed to be easily replaceable with the final prosthesis after the healing period.
- Provisional Crown Relining: The provisional crown was relined to fit accurately onto the temporary abutment. This step ensures the crown provides proper function and esthetics while the implant integrates with the bone.
- Provisional Restoration on #22: The provisional crown was placed on the abutment, restoring the patient’s esthetics and function immediately. This temporary solution helps in maintaining the gingival contour and patient comfort.
- Immediate Post-Surgery and Follow-Up: Immediate postoperative images were taken to document the initial success of the procedure. The patient was monitored regularly, with a follow-up period extending to 5 months, to ensure proper healing and integration of the implant.
- Final Prosthesis on #22: After confirming the successful osseointegration of the implant, the provisional restoration was replaced with the final prosthesis. The final crown was custom-made to match the patient’s natural dentition, providing optimal esthetics and function.
Conclusion
- Tooth fractured and root rest state on Lt. maxillary anterior area
- Atraumatic extraction (22i) with periotome with horizontal crack
- Placed with OneGuide – Immediate and restoration placement after extraction
