The patient is a 40 year old, non-smoking female. She wanted a fast and aesthetic solution for tooth #14 (5). The treatment plan is a single surgery with an immediate implant and closed sinus life to replace teeth #14 (5) and #16 (3).
The patient is deeply concerned by the aesthetic problem on tooth #14 (5). She is asking for an efficient, provisory solution. Nevertheless, if the loss of tooth #16 (3) is not promptly solved, it may cause the loss of tooth #15 (4). The proposal is to replace both the premolar and molar in one, single surgery.
The treatment is to extract tooth #14 (5) with immediate implant placement, grafting and immediate loading. For tooth #16 (3) – implant placement with a closed sinus lift (Summers technique) with grafting. It is decided to use Augma Bond Apatite® with 2 different protocols.
2 Comments
Hi, when placing an immediate implant is it recommended to place bone cement in the whole osteotomy , wait for it to set and then make the final osteotomy and insert the implant?
I saw some in Augmaflix cases done that way.
This case looks like the bone cement is only placed AFTER the implant inserted.
The following is a reply from Dr Stéphane Berg:
Immediate implant placement is always a new challenge.
The time of the grafting depends on the following:
– The volume needed to complete the process.
– The type of bone loss.
When the implant is large enough, and the bone loss is reduced, then I graft before placing the implant. I drill without water, very low speed, reverse clockwise rotation in order to condense the material.
When the bone loss is larger, I perform implant placement before grafting so that I will have the opportunity to press the material directly.
In both cases, I add some graft on top of the implant.