A 45 yr old lady had a missing right 1st premolar. She wanted to replace the tooth with a fixed partial denture. Considering the region where the tooth was going to be replaced, I gave her the option of an implant. But in the esthetic zone (the upper anterior area along with the premolar area is considered the esthetic zone) due to high and early resorption of the bone after extraction, bone grafting was done.
I placed Frialit-2 implant in her mouth. She was given esthetic temporaries so she could smile nicely without being conscious of her missing tooth. After 6 months the implant was osseointegrated and ready for 2nd stage surgery. Then gingiva former was placed on her implant to contour the gum around the implant. I took impressions of the implant system and cemented the permanent crown as soon as it was ready.
After 4 years of implant placement with regular check ups, the implant tooth is still going strong and the patient is still smiling.
A male patient age 55 came with swelling and abscess in the lower right 1st premolar (pic 1). After examination, extraction of the tooth and immediate implant placement was planned. The 2nd premolar and 1st molar were missing. After the flap was raised one could see the evidently see vertical fracture of the 1st premolar (pic 2).
Tremendous bone loss on the buccal surface along with granulation tissue surrounding the apical region could be seen. The tooth was extracted and the cyst was enucleated (pic 3). 3 root- form implants were placed in the lower right region (pic 4 & 5).
Bone grafting along with the use of Plasma Rich in Growth Factors (PRGF) technique (pic 6) was applied. Cellular membrane was placed over the bone graft (pic 7). After healing period (pic 8) of 3 months, implants were osseointegrated and abutments were placed (pic 9). On top of the abutments, implant supported tooth – colored prosthesis was placed (pic 10 & 11)