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Clinical case Wim Van Thoor Edge 6
clinical case

Immediate placement of a Neoss ProActive® Edge implant in compromised bone

Dr. Wim van Thoor, Germany
Certified Implantologist
Kirchhoven, Germany

Case facts

Patient: 

31-year old female in good health

Clinical problem: 

Failing upper left first premolar after two previous root resections, broken crown.

Treatment plan: 

Tooth extraction and immediate placement of a Neoss ProActive® Edge implant with simultaneous bone grafting using THE Graft (Purgo).

Step by step

Step by step

  • Clinical case Wim Van Thoor Edge 1
    Figure 1.

    The patient presented with a failing upper left first pre-molar. The CBCT shows the initial situation (Figure 1).

  • Clinical case Wim Van Thoor Edge 2
    Figure 2.

    Note what seems to be a big buccal fenestration in the area of the resected root (Figure 2).

  • Clinical case Wim Van Thoor Edge 3
    Figure 3.

    The broken tooth was extracted (Figure 3–4).

  • Clinical case Wim Van Thoor Edge 4
    Figure 4.

    The broken tooth was extracted (Figure 3–4).

  • Clinical case Wim Van Thoor Edge 5
    Figure 5.

    An access flap was lifted, revealing the buccal fenestration (Figure 5).

  • Clinical case Wim Van Thoor Edge 6
    Figure 6.

    The osteotomy was prepared according to the Neoss ProActive® Edge drill protocol (Figure 6).

  • Clinical case Wim Van Thoor Edge 7
    Figure 7.

    Placement of one ∅5.0 × 13 mm Neoss ProActive® Edge implant (Figure 7).

  • Clinical case Wim Van Thoor Edge 8
    Figure 8.

    The implant was placed in very limited bone quantity of medium bone density (Figure 8). Good primary stability was reached despite the limited bone situation. The insertion torque was 20 Ncm and ISQ was 70/77.

  • Clinical case Wim Van Thoor Edge 9
    Figure 9.

    THE Graft (Purgo) cancellous bone granules (Figure 9) were used to correct the buccal fenestration (Figure 10).

  • Clinical case Wim Van Thoor Edge 10
    Figure 10.

    THE Graft (Purgo) cancellous bone granules (Figure 9) were used to correct the buccal fenestration (Figure 10).

  • Clinical case Wim Van Thoor Edge 11
    Figure 11.

    The bone graft was covered with a resorbable collagen membrane (Figure 11).

  • Clinical case Wim Van Thoor Edge 12
    Figure 12.

    The mucosal flap was sutured around the PEEK healing abutment, allowing for one-stage healing (Figure 12).

  • Clinical case Wim Van Thoor Edge 13
    Figure 13.

    Radiograph showing the implant at time of insertion (Figure 13).

  • Clinical case Wim Van Thoor Edge 14
    Figure 14.

    A Neoss ScanPeg was attached to the healing abutment (Figure 14), and the site was digitally scanned using an intraoral scanner (Figure 15).

  • Clinical case Wim Van Thoor Edge 15
    Figure 15.

    A Neoss ScanPeg was attached to the healing abutment (Figure 14), and the site was digitally scanned using an intraoral scanner (Figure 15).

  • Clinical case Wim Van Thoor Edge 16
    Figure 16.

    The CBCT after 3.5 months healing (Figure 16) shows good integration of the Edge implant and bone regeneration in the initial defect. The ISQ had increased to 72/79 further indicating good integration.

  • Clinical case Wim Van Thoor Edge 17
    Figure 17.

    Using a completely digital workflow, an individualized zirconia abutment was fabricated on a Neoss TiBase (Figure 17) and a zirconia crown was fitted on the abutment (Figure 18).

  • Clinical case Wim Van Thoor Edge 18
    Figure 18.

    Using a completely digital workflow, an individualized zirconia abutment was fabricated on a Neoss TiBase (Figure 17) and a zirconia crown was fitted on the abutment (Figure 18).

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