Winter 2007 - Biomet 3i

T E C H N O L O G Y I N M O T I O NImmediate Implant Placement And ProvisionalizationWith A NanoTite Certain ® PREVAIL ® Implant And PreFormance ® PostImplant with an audible and tactile click to confirmproper seating. Minor modifications were performedintraorally with a coarse diamond and high-speedhandpiece using copious irrigation. Then, themodified post was removed for minor extraoraladjustments and polishing with a carbide bur andgreen stone on a slow speed handpiece (Figure 4).A polycarbonate crown shell was selected andrelined intraorally over the modified abutment.The abutment and crown were removed and themargins of the crown were refined extraorally. Afterpolishing, the PreFormance Post was placed backinto the implant and the abutment was securedwith an abutment screw tightened to 20Ncm. Thecrown was cemented with temporary cement anda periapical radiograph was taken to ensure therewas no remaining cement in the sulcus (Figure 5).The crown was adjusted out of occlusal andinterproximal contacts following the principlesfor immediate non-occlusal loading (Figure 6).Figure 1Figure 2Figure 7Figure 8After five weeks, the provisional crown wasremoved revealing healthy soft tissue surroundingthe PreFormance Post (Figure 7). The PreFormancePost was then removed and an Osstell Smartpeg was placed into the implant (Figure 8) to measurethe stability of the implant. An ISQ value of 70confirmed that the implant was very stable andcould therefore receive a definitive restoration.Figure 3Figure 9An Impression Coping 3.4mm(D) was placed(Figure 9) and an impression was made with afirm body impression material. An impressionof the opposing arch, a bite registration andshade were sent to the dental laboratory forfabrication of a custom abutment and a Captek crown. The PreFormance Post and provisionalcrown were replaced.Figure 4Figure 10Upon receipt of the definitive restoration from thelaboratory, the provisional crown was removed andthe custom abutment was placed into the internalinterface of the implant (Figure 10) with an audibleand tactile click to ensure complete seating. Aperiapical radiograph was also taken. The customabutment was then secured with a Gold-Tite ®Abutment Screw tightened to 20Ncm. The definitivecrown was tried in, followed by adjustment of theocclusion and interproximal contacts, then cementedwith Temrex ® Cement (Figure 11). The patient’streatment was concluded with a natural looking,implant-supported restoration in nine weeks afterextraction of the failed tooth (Figure 12).Figure 5Figure 11Figure 6Figure 125