Immediate placement of 3 implants, Scanning, ISQ measurement. Arum implant system. > DENTAL FORUMS

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  A 53-year-old male patient has some systemic issues; hypertension (controlled), diabetes(controlled), and has been smoking for 3 decades (at least). He had Ortho-Tx. history.
  Lower left premolar and molars extraction and immediate placement of 3 implants: 4 unit cantilever-type implant-supported fixed partial denture was scheduled due to the condition of personal insurance coverage. (when an existing natural tooth is replaced with an implant, the patient can be paid back by the insurance company).

  Pre-op Intraoral photo



  Pre=op panoramic radiograph.





   Surgery simulation to find the optimal size, position, and direction of implants.

 

  tooth extraction


  implants placement


  2nd premolar –Arum NB Ø4.0L10 (30Ncm), 1st molar-Arum NB Ø5.0L10 (40Ncm), 2nd molar-Arum NB Ø5.0L10 (30Ncm),
 

  The socket area was filled with graft material(xeno-graft).
 

  Collagen membrane was placed on the grafted area.


  The flap was closed.
 

  CBCT scan images


  Intraoral view shows the healing status of post-op 7 weeks.


  11 weeks after the placement of implants. ISQ measurement at the implant of 2nd premolar position.
 

  11 weeks after the placement of implants. ISQ measurement at the implant of the 1st molar position.
 

  11 weeks after the placement of implants. ISQ measurement at the implant of the 2nd molar position.
 

  Healing Abutments were replaced with those of other sizes to get the optimal form of the gingiva.
 

  Panoramic radiograph (post-op 12 weeks).


  Re-measurement of ISQ at the 1st molar. In 3weeks, the value of ISQ was improved by 5.23%.


  Intraoral scanning with scan abutment engagement for the fabrication of customized abutments and restoration.


  Abutments were seated using an orientation jig.


  Connecting screws were tightened according to recommended torque force(35~40Ncm).


  The restoration was seated onto the abutment.


  The restoration was cemented permanently and the access hole was filled with composite resin.       


  The panoramic radiograph.

 

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