PMC3134053_01
Pre-operative
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F1
On clinical examination it was noted that the patient had a missing mandibular right first molar (tooth number 46) [Figure 1].
Pre-operative radiograph
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F2
It was decided to place a 5.3 diameter, 13 mm long implant [Figure 2]. The main trunk and the mental foramen were located in the area between the apices of the two premolars [Figure 2].
Accessory mental nerve and foramen along with the buccal dehiscence on the implant
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F3
The foramen and the fiber were identified as accessory mental foramen and nerve [Figure 3].
Dehiscence covered with titanium mesh and bio-oss
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F4
The exposed threads were covered with bovine anorganic bone [Bio-oss, Geistlich Pharma AG, Wolhusen, Switzerland] and stabilized with a titanium mesh screen [Synthes, CO, USA], of 1.0-mm sized pores which was contoured to the defect [Figure 4] During grafting, care was taken so that the nerve fiber was not traumatized.
Immediate post implant placement radiograph
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F5
A radiograph was made to assess the placement of implant in relation to the inferior alveolar canal [Figure 5].
Final restoration
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F6
The final restoration was cemented [Figures 6 and 7] and the patient was put on a follow-up care. The patient is being currently followed up since the past two years.
Radiograph of the final restoration
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F7
The final restoration was cemented [Figures 6 and 7] and the patient was put on a follow-up care. The patient is being currently followed up since the past two years.