PMC4974829_01
Defect limited exclusively to the bucco-lingual direction with concavity due to bone loss.
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F1
Clinical and Radiographic images were taken pre-operatively (Figs. 1-2).
Initial periapical radiograph of the case with normal ridge height.
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F2
Clinical and Radiographic images were taken pre-operatively (Figs. 1-2).
Osteotomy preparation with osteotome technique.
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F3
Because there was a degree of resistance, the ridge was allowed to spread for 30 to 60 seconds with the osteotome left in place before the next-size-larger osteotome was used (Fig. 3).
The final diameter of the imlant bed was established and the crestal bone thickness reached 6.35 mm bucco-lingually.
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F4
After the final diameter of the implant bed was established and the crestal bone thickness reached 6.35 mm (Fig. 4), a 10-mm-long, 4.1-mm-diameter standard-neck, nonsubmerged sandblasted and acid-etched (SLA) screw-type ITI implant (Straumann Ch Company of Basel, Switzerland) was immediately placed after the bone expansion was completed and a healing abutment 2 mm in height was added (Fig. 5) Leaving the osteotomy slightly narrower than the diameter of the implant allowed the implant to self-tap and achieve good primary stability.
Implant in position with healing abutment 2 mm in height was placed at the implant installation.
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F5
After the final diameter of the implant bed was established and the crestal bone thickness reached 6.35 mm (Fig. 4), a 10-mm-long, 4.1-mm-diameter standard-neck, nonsubmerged sandblasted and acid-etched (SLA) screw-type ITI implant (Straumann Ch Company of Basel, Switzerland) was immediately placed after the bone expansion was completed and a healing abutment 2 mm in height was added (Fig. 5) Leaving the osteotomy slightly narrower than the diameter of the implant allowed the implant to self-tap and achieve good primary stability.
Periapical radiograph immediately after implant insertion.
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F6
The implant position was visible on periapical radiograph immediately after implant insertion (Fig. 6).
Intraloral view after 6 weeks of healing with good soft-tissue healing.
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F7
Six weeks postsurgery, the patient showed good soft-tissue healing (Fig. 7).
Prepared abutment in place.
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F8
A prosthetic abutment was inserted with 35 Ncm of torque, and the reconstruction was issued (Fig. 8).
Final prosthesis in place.
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F9
The implant was loaded and restored with a porcelain-metal retainer (Fig. 9).
Preiapical radiograph showing the implant and surrounding bone one year after the restoration and functional loading of the implant.
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F10
A radiograph taken at 12 months showed a stable clinical situation in the area around the apices of the implant (Fig. 10).