This is a dental implant immediate tooth replacement case that I did in my Burbank office a few days ago. There are many details that make this dental implant unique. He only lost this tooth about six months ago, and the bone had already shrank, causing an indentation defect on the critical outer wall of the bone.
Notice the pre-operative picture with the bone void. If nothing is done to correct this, the tooth will look funny. It will be long, and may have black triangle holes on each side. Being from Los Angeles and being in sales, this would not be an acceptable appearance.
For this bone graft implant procedure, I flapped open the gum just enough to see the edge, and actually bent his bone using a “D-shaped” device called an osteotome. He elected to have the procedure while he slept under IV sedation in my office in Burbank.
A 3.7 x 13mm internal hex dental implant was placed as the final expander and the semi custom zirconia abutment was torqued into place. I stitched the gums on either side of the zirconica dental implant abutment, and made a temporary that cemented to the implant.
You can see that the bone widened significantly, and is now even with the other tooth. These pictures are taken on the day of the surgery!
What makes his situation even more tricky is his overbite. This tiny detail can cause an early failure where the implant would loosen. On immediate dental implants, the temporary must be made to not touch the opposing tooth. You have to stay off of the temporary dental implant tooth for about 2-4 months, on average, for the implant to heal. After it heals, the final all-porcelain lithium disilicate crown will be made.
I will follow up on this case in the future so you can see the final result. He was thrilled not to have to wear the temporary denture anymore, as he is only about 40 years old!
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology/Implant Dentistry