A 49 year old patient had repeated troubles with tooth 26. After an attempt of preserving the tooth endodontically, the tooth had to be extracted nevertheless. The extraction was carried out by a dentist in France (as the patient was on vacation in France at the time). Based on the well-preserved neighboring teeth, I recommended an implant-supported restoration to the patient. The bone seemed compact on the x-ray image, but a clinical examination showed that the buccal area was a bit sunken and narrow. The x-ray image also showed that the availability of vertical bone was limited extremely by the sinus. An evaluation with a template showed a bone height of about 8 to 8.5 mm. As the patient refused a sinus lift (risk of perforation of the sinal mucosa and extended healing times), I decided on inserting an IMPLA Cylindrical Implant with a diameter of 5.4 mm and a reduced length of 8.0 mm.
After conditioning the implantation site a cylindrical implant by Schütz Dental GmbH was inserted. IMPLA Cylindrical ensures an extremely high primary stability. Afterwards, a periosteal incision was made and the buccal bone was augmented with a bone graft material and a membrane (Bio-Oss and Bio-Gide foil). Therefore, submerged healing was indicated. Subsequently, the mucous membrane was closed with button sutures.
The implant was uncovered with help of the gingiva punch, then the necessary impressions and a mush bite were taken. The individual abutment was placed on top of the implant and the metal-ceramic crown was fixed in a semi-permanent way with TempBond.
The result is a very good red/white aesthetic, as neither gingiva nor marginal bone have degenerated. Furthermore, a formation of pockets around the implant shoulder could not be detected and the x-ray image showed good healing and integration of the implant into the bone.