Conical Case Study
Diagnostics
Age: 34
Gender: Male
#25 tooth with old root canal treatment that failed
Generally healthy, no drugs
Treatment Plan
#25 extraction with implant placement with a healing screw
After 6 months replace the healing screw with a temporary crown and after replace it with Zircon crown.
Operation
Operation Date: 03/09/15
#25 extraction with implant placement with healing screw and 5/0 nylon stitches that were removed after 7 days.
Chosen Implants: Position 25: Ø4.2 / 11.5mm - Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant
2. After 6 months replace the healing screw with a temporary crown and after replacing it with Zircon crown.
3. The follow-up checks dental X-ray of one year after implant placement shows no marginal bone resorption and progressive bone healing of the extraction alveoli.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
OP one year after the bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc
Diagnostics
Age: 40
Gender: Male
Tooth: #36
Tooth #36 is missing.
Generally healthy,
no drugs light Smoker (5-10 cigarettes per day).
Treatment Plan
Implant placement at #36 with a cover screw. After 3 month reentry for replacing cover screw to healing screw. A couple of weeks later putting a temporary bridge and replace it with a ceramic crown.
Operation
Operation Date: 13/03/15
Implant placement at #36 with a cover screw and 5/0 nylon
stitches that were removed after 7 days
Chosen Implants:
Position 36: Ø5 / 10.5mm - Dynamix
Clinical Follow-Up
1. 3 months later replace the temporary crown with a Ceramic crown.
2. The follow-up check dental X-ray of 9 months after implant placement shows no marginal bone resorption and progressive bone healing of the extraction alveoli.
3. The follow-up check dental X-ray of 1 year and 6 months after implant placement shows no marginal bone resorption and progressive bone healing of the extraction alveoli.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Diagnostics
Age: 49
Gender: Female
Teeth: #36
Tooth #36 is missing
Low blood pressure, Aspirin, and smoking.
Treatment Plan
Implant placement at #36 with a cover screw. After 3 month reentry for replacing cover screw to healing screw. A couple of weeks later putting a temporary bridge and replace it with a ceramic crown.
Operation
Operation Date: 05/06/14
Implant placement at #36 with a cover screw and 5/0 nylon stitches that were removed after 7 days.
Chosen Implant:
Position 36: Ø4.2 L10mm - Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 3 months later replace the temporary crown with a ceramic crown.
3. The follow-up check dental X-ray of 1 year and 6 months after implant placement shows no marginal bone resorption and progressive bone healing of the extraction alveoli.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc..
Diagnostics
Age: 55 Gender:
Gender: Female
Tooth: #44, #45, #46 are misssing
High blood pressure controlled with drugs and Altroxin for Thyroid gland.
Treatment Plan
Teeth: #45, #46, #47 implants placement and wait for 3 month. After 3 month reentry for replacing cover screw to healing screw. A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge.
Operation
Operation Date: 06/08/14
Teeth: Placing 3 implants #45, 46, 47 with a cover screw and 5/0 nylon stitches that were removed after 7 days.
After 6 month reentry for replacing cover screw to healing screw.
A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge.
Chosen Implants:
Position 44: Ø4.2, L13mm – Dynamix
Position 45: Ø4.2, L13mm – Dynamix
Position 46: Ø4.2, L13mm – Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 3 months later reentry and putting 3 healing cups.
3. 4 months later putting a temporary bridge and replace it with a ceramic bridge.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Diagnostics
Age: 57
Gender: Female
Teeth: #34, #36
Old bridge #33, #35, #36 (cantilever) broke dawn, #37 with a big hall.
Low blood pressure and Altroxin for Thyroid gland
Treatment Plan
Teeth: #35 extraction with Saturn implant placement and #34, #36 Conical Dynamix implants placement and waits for 3 months
After 3-month reentry for replacing cover screw to healing screw.
A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge
Operation
Operation Date: 14/08/14
Implant placement.
Chosen Implants
Position 34: Ø4.2 L13mm – Dynamix
Position 36: Ø4.2 L11.5mm – Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 3 months later reentry and putting 3 healing cups.
3. 4 months later putting a temporary bridge and replace it with a ceramic bridge.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Diagnostics
Age: 48
Gender: Male
Teeth: #36, #37 Missing
Teeth #36, 37 are missing. High blood pressure controlled with drugs, Aspirin as prevention and Omepradex for reflox.
Treatment Plan
Teeth: #36, #37 implants placement and wait for 3 months. After 3-month reentry for replacing cover screw to healing screw. A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge
Operation
Operation Date: 03/09/14
Placing 2 implants #36, 37 with a cover screw and 5/0 nylon stitches that were removed after 7 days
After 3 months reentry for replacing cover screw to healing screw.
A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge
Chosen Implants:
Position 36: Ø4.2 /L10mm – Dynamix
Position 37: Ø4.2 /L10mm – Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 3 months later reentry and putting 3 healing cups
3. 4 months later putting a temporary bridge and replace it with a ceramic bridge.
4. The follow-up check dental X-ray of 1 year and 4 months after implant placement shows no marginal bone resorption and progressive bone healing of the extraction alveoli.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Diagnostics
Age: 62
Gender: Female
Teeth: #16, #17, #26, #27 are missing
Diabetic controlled with drugs and Altroxin for Thyroid gland
Treatment Plan
Teeth: The treatment will be in two stages
First Implants placement at #16, #17 with cover screw
After 6 months reentry for replacing a cover screw to healing screw on
#16, #17 and Implants placement at #26, #27 with cover screw
A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge on #16, #17.
After 6 months reentry for replacing cover screw to healing screw on #26, #27.
A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge.
Operation
Operation Date: 10/06/15
Implants placement at #16, #17 with a cover screw and 5/0 nylon stitches that were removed after 7 days.
Operation Date: 05/11/15
Implants placement at #16, #17 with a cover screw and 5/0 nylon stitches that were removed after 7 days.
Chosen Implants:
Position 16: Ø4.2 /L10mm – Dynamix
Position 17: Ø4.2 /L10mm– Dynamix
Position 26: Ø4.2 L13mm – Classix
Position 27: Ø4.2 L11.5mm – Classix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 6 months later replace the temporary bridge with Ceramic bridge
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc
Diagnostics
Age: 57
Gender: Female
Teeth: #14, #15, #16, #17, #24, #26, #27, #36, #37 are missing
Low blood pressure, Aspirin as prevention and Altroxin for Thyroid gland
Treatment Plan
Teeth: Implants placement at #14, #15, #16, #17, #24, #26, #27, #36 and #37 with cover screw.
After 6-month reentry for replacing cover screw to healing screw.
A couple of weeks later putting a temporary bridge and replace it with a ceramic bridge.
Operation
Operation Date: 23/06/15
Implants placement at #14, #15, #16, #17, #24, #26, #27 with cover screw, #36, #37 with healing screw and 5/0 nylon stitches that were removed after 7 days.
Chosen Implants:
Position 14: Ø3.8 / L13mm – Dynamix Position 26: Ø3.8 / L11.5mm – Dynamix
Position 15: Ø3.8 / L11.5mm – Dynamix Position 27: Ø4.2 / L10mm – Dynamix
Position 16: Ø4.2 / L10mm – Dynamix Position 36: Ø3.8 / L11.5mm – Dynamix
Position 17: Ø4.2 / L10mm – Dynamix Position 37: Ø3.8 / L11.5mm – Dynamix
Position 24: Ø3.8 / L13mm – Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 6 months later replace the healing screw with abutments and a temporary bridge
3. After couples of weeks replace it with a ceramic bridge.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Diagnostics
Age: 41
Gender: Male
Tooth: #36 with old root canal treatment that failed and should be extracted.
Smoker, Healthy
Treatment Plan
Tooth: Extraction with Implant placement at #36 with a cover screw
After 3-month reentry for replacing cover screw to healing screw
A couple of weeks later putting a temporary crown and replace it with a ceramic crown.
Operation
22/07/15
Extraction with Implant placement at #36 with healing screw and 5/0 nylon stitches that were removed after 7 days.
Chosen Implants:
Position 36: Ø4.2 /L11.5mm – Classix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant
2. 3 months later replace the temporary crown with a ceramic crown
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc
Diagnostics
Age: 60
Gender: Female
Teeth: #44, #45, #46 are missing.
Smoker, Diabetic that control by drugs, High blood pressure that control by drugs and Altroxin for Thyroid gland.
Treatment Plan
Teeth: Implant placement at #44, #45, #46 with healing screw.
After 3-months replace the cup with a temporary bridge with a ceramic bridge.
Operation
Operation Date: 10/09/15
Insertion implants at #44, #45, #46 with a cover screw.
Chosen Implants:
Position 44: Ø3.8 /L13mm – Dynamix
Position 45: Ø4.2 /L10mm – Dynamix
Position 46: Ø3.8 /L11.5mm – Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 3 months later replace the cover screw to a temporary bridge and then for a ceramic bridge.
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Diagnostics
Age: 39
Gender: Female
Tooth: #36 should be extracted due to failing old root canal treatment.
Healthy smoker
Treatment Plan
Tooth: Extraction and Implant placement at #36 with a healing screw
After 3 months replacing healing screw with a temporary crown and replace it with a ceramic crown.
Operation
Operation Date: 29/04/15
Implant placement at #36 with a cover screw and 5/0 nylon stitches that were removed after 7 days.
Chosen Implants:
Position 36: Ø4.2 /L11.5mm – Dynamix
Clinical Follow-Up
1. The patient had no pain, no swelling of gingiva and failure of osseointegration of the implant.
2. 3 months later replace healing screw with a temporary crown and then replace with a ceramic crown.
No peri implanter disease
Conclusion
There were no signs of peri-implantitis around the implants on none of the follow-up OP after implant placement, no fibrosis, and no bone loss value.
The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc. without fatty infiltration, granuloma, etc.
Diagnostics
Age: 56
Gender: Female
Tooth: #15 & #36 root stump, #45 & #46 are missing
Healthy non-smoker
Treatment Plan
Complete Oral Prophylaxis was done, and patient was kept on antibiotic prophylactic therapy of tab. Implant surgery was planned after 3 days.
Operation
Operation Date: 26.07.2019
Under LA root stumps with #15 & #36 region were extracted and immediate implant placement was done. Delayed placement was done in #45 & #46 region, soft tissue reconstruction surgery was done gain more keratinized peri-implant tissue around the implants by famous Palacci technique. Cover Screw was placed on #36 region implant and closure was achieved placing Geistlich Mucograft Seal and healing abutments were placed on #15, #45 & #46 region implants m aking it single stage surgery. Closure was achieved using 4.0 Cytoplast sutures. Implant placement was done free hand without using any stent or guide.
Operation
Operation Date: 26.07.2019
Chosen Implant:
Position 15: Ø4.2/ 13mm – Dynamix
Position 36: Ø5.0/ 10mm – Dynamix
Position 45: Ø3.8/ 10mm – Dynamix
Position 46: Ø4.2/ 10mm – Dynamix
Clinical Follow-Up
Patient was asked to get Cold Packs for 24 hrs to reduce swelling. Medication was continued along with Tab. Flozen AA (Acelofinac + Paracetamol) twice daily & Chlorhexidine mouthwash 5 days. Patient is recalled after 7 days for Suture removal.
Conclusion
Immediate implant placement is always better option than delayed placement as augmentation procedures are prevented and Palacci Technique gives much better Peri-Implant Tissue. Single stage surgery gives much better patient compliance with a pre-requisite of high Initial Stability of 45+ ncm and High ISQ value of more than 60.
Diagnostics
Age: 50
Gender: Male
Tooth: #16 is missing
Healthy non-smoker
Treatment Plan
Complete Oral Prophylaxis was done, and patient was kept on Antibiotic Prophylactic Therapy of Tab. Augmentine – 625 mg (Amoxicillin + Clavulenic acid) Twice Daily for 7 days & Chlorhexidine mouthwash was advised twice daily at the time of Consultation. Implant Surgery was planned after 3 days
Operation
Operation Date: 12.08.2019
Under LA least Traumatic Flapless Surgery was done using Tissue Punch in #16 region & Implant Placed. Healing abutment was placed in #16 region Implant making it a Single Stage Surgery. Implant Placement was done Free hand without using any Stent or Guide conveniently as ample amount of Hard & Soft was present due to Ridge Preservation procedure which was done 24 weeks earlier.
Chosen Implant:
Position 16: Ø6.0/ 10mm – Dynamix
Clinical Follow-Up
Patient was asked to get Cold Packs for 24 hrs to reduce swelling. Medication was continued along with Tab. Flozen AA (Acelofinac + Paracetamol) twice daily & Chlorhexidine mouthwash for 5 days. Patient was recalled after 7 days for Follow-up.
Conclusion
Delayed Implant Placement procedure becomes a mandatory option than Immediate Placement to prevent incorrect Prosthetic positioning of Implant after Ridge Preservation Procedures when Implant placement & initial stability is compromised due hard & soft tissue deficiency. Case Selection & planning is very important for long term success & predictability. Single Stage Surgery gives much better patient compliance with a pre-requisite of high Initial Stability of 45+ ncm and High ISQ value of more than 60.
