PMC3654637_01
Preoperative view of the posterior left first molar, number 36.
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After two months, the patient reported back again for the prosthetic replacement of the molar (Figures 1 and 2).
Preoperative radiograph of tooth, number 36, note the good height of the alveolar bone.
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fig2
After two months, the patient reported back again for the prosthetic replacement of the molar (Figures 1 and 2).
Crestal incision made along the crest of the ridge.
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Briefly, after induction of local anesthesia, a crystal incision was made along the crest of the ridge using Bard-Parker number 12 surgical blade, bisecting the existing keratinized mucosa (Figure 3).
Broad buccolingual width of the residual ridge.
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A full thickness mucoperiosteal flap was raised buccally and lingually to the level of mucogingival junction, exposing the underlined ridge of the implant site, and a ridge alveoplasty was performed with the help of 0.2 mm round bur to achieve a flat bone surface of sufficient width (Figure 4).
Pilot drill is used to increase the osteotomy site to confirm position and angulation.
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After pilot drill application, the implant site was prepared with the corresponding size of parallel drill (Figure 5).
Wrench used for tightening implant.
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The implants were placed in the recipient site by means of an insertion device, and a torque driver set at 35 N cm which was used to evaluate primary stability of implant (Figure 6).
Implant placed into the osteotomy site.
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The implant neck was positioned at the crystal bone level or slightly submerged (Figure 7).
Radiographic view of the implant after surgery.
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Intraoral periapical radiograph was taken immediately after surgery (Figure 8).
Clinical view of the final restoration at six weeks after surgery.
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The temporary restoration was replaced with permanent restoration after six weeks (Figure 9).
Clinical view of the final restoration at 12 months after surgery.
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The crown restoration was cemented and followup of one year of implant survival was assessed (Figure 10).