Expanding a case

Categories ; Anterior, Posterior, Grafting, Multiple implants, Nobel Biocare

Failing teeth with advanced boneloss

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Extraction after creating posterior implant support

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Healing at 3 months , note less density at cuspid site

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Over extended impression acquiring a large part of the edentulous ridge

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BLP locks in the Bucco-lingual position and the shoulder of the implant,a 3.5 mm implant will be selected

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BLP glued in at premolar site, a 4.3 mm implant will be selected

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The wings are bonded to the vacuform carrier

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The clinical situation, note how the molar implant does create posterior support, while the anterior situation is under treatment

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The buccal has been cut short for easy flap management

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Drills set at 8.5 mm ( 13 – 3 – 1.5)

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Radiograph shows that an additional 1.5 mm, for 10 mm implants is OK

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Preparation now made for 10 mm implant, note green 1.5 mm flexistop was removed

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Last drill with additional 3 mm flexistop for stepped back preparation for tapered implant

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Premolar site is tapped with guided tap from Nobel Biocare

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Bone particles are collected

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Incomplete healing at cuspid site, osteotomies are completed

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Implants are placed

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Final torque, with good initial stability, 3.5 x 10 and 4.3 x 10 Nobel Active

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Buccal defect, although body of implant is within bone contour.

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Bone collected

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Defect is grafted with collected bone particles

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Submerged healing as patient is wearing a stay plate

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Implants placed as planned, submerged healing.

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