Surgical guide, complicated case requires temporary aesthetic restoration

Tooth and gingival (soft tissue) - with flap or flapless

Surgical guide, complicated case requires temporary aesthetic restoration

Dr. Gustavo Yatzkaier.
Patient (F, 48) referred for tooth extraction 44-48 and four immediate implants 44-45-46-47. The patient indicated her preference for a temporary aesthetic solution, but declined a removable partial denture.
Inspection of initial CT (Fig. 1) and consultation with her oral rehabilitation doctor indicated buccal plate deficiency, and the decision was made to perform a staggered treatment:

Stage 1: Extractions 44-48, placing 4 immediate implants 44-45-46-47.
For implants 45-46-47, immediate loading will be applied. Implant 44 will remain unexposed due to the need for a bone transplant. Rehabilitation with a temporary bridge on implants, including dental pontic 44. Temporary rehabilitation to be performed without buccal contact.
Stage 2: Exposing implant 44 after three months.

Clinical view with bridge before procedure.

After extractions 44-48.

ABGuidedService plan-The Sagittal Images for all implants

ABGuidedService plan

Pre-op testing of buccal tube

View of 3 parallel implant pins in the 45-46-47 zone after initial drilling with pilot drill

View of implant 44 in need of augmentation and implants 45-46-47 structure attachment with screws for immediate loading

Filling implant 44 zone with human-derived bone allografts (DFDBA)

Pericardium membrane augmentation in the 44 zone

After closing the flap

Post-op periapical X-rays

3-month follow-up after exposure of implant 44

Following exposure of implant 44

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