3.0 mm Narrow Diameter implants in very thin ridges

Categories ; Anterior, Grafting, Nobel Biocare

Congenitally missing upper laterals

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Orthodontic space management

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Covered lingual brackets during vacu form fabrication

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Very tight, once site 4 mm, the other 3 mm

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Bone calipers measure indeed 3 mm, showing how accurate bone sounding is.

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Bone calipers measure indeed 3 mm, showing how accurate bone sounding is.

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BLP position relative to alveolar crest

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Screw access hole relation relative to future crowns

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Narrow diameter buccal wings

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Wings attached to vacuform carrier with PMMA ortho resin

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Surgical guide can be evaluated while lateral pontics are still in place

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Surgical guide can be evaluated while lateral pontics are still in place

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No need for rotational adjustment, so use green 0 degree rotation blocks

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0 degree rotation blocks in place, pontics have been removed

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Papilla spearing incision with broad base

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Vacuform used to adjust the crest height for good emergence profile

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Desire to have implant top 2-3 mm below gingival margin, necessitates bone reduction

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1.5 mm drill, using custom made 1.5 mm drill guide

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Initial osteotomy.

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BTI bone expanders

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BTI bone expanders , increasing diameter.

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2.0 mm drill at 11.5 mm ( green Flexistop)

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2.8 mm drill at 8.5 mm , step back preparation for tapered implant

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Guided tap, set at 12 mm

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Final osteotomy

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3.0 Nobel Active implant

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Implant placed at predetermined position

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Bio-oss grafting

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Protected with double resorbable membrane

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Combination of suture materials and thicknesses.

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Same on the other side

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Final osteotomy

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Implant placed at the predetermined position

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Lingual fenestration ,as planned, will be grafted with bio-oss and collagen membrane

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Bio-oss will be covered with double collagen membrane

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Implants placed as predetermined

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Cyano acrylate coverage

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Pontics back in place.

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