implants international magazine of oral implantology

case report I meeting all the requirements concerning their general health, also exhibited the conditions necessary for the technique of bone expansion. The materials selected were countersinks and conical implants (Implacil De Bortoli;Figs.1a&b).Thedesignofthecountersinkmust beappropriatetoexpandthedesignoftheimplant. _Case presentation CaseI A 21-year-old male patient presented to the clinic (Bioface Cirurgia Oral e Maxilofacial) for the replace- ment of tooth #11 with an implant. After a detailed anamnesis, it was found that the patient had no sys- temic involvement. From the clinical and radiographic examinations,wewereabletoverifythenecessarycon- ditions for the realisation of the expansion technique, followed by the immediate placement of the implant (Figs.2a&b). After obtaining consent to the proposed treatment plan,treatmentwasbegun.Aftertheinitialperforation witha2mmdrill,establishingthepositionanddepthof the implant (Fig. 3), the countersink sequence was fol- lowedinordertoexpandthevestibularwallofthealve- olus. The green colour corresponds to the countersink for a 3.5 mm conical implant (Fig. 4) and the blue to a 4 mm conical implant (Fig. 5). After this sequence, the site was finished (Fig. 6), an internal conical implant of 4.0 x 11 mm was inserted in the place of tooth #11 (Fig.7)andthesitewassutured(Fig.8).Aprescriptionof 875 mg amoxicillin to be taken two hours before the procedurewasgiventothepatientaspreventivemed- ication.Hewasalsoinstructedtotakethesameamount ofamoxicillintwiceadayforfivedaystopreventpost- operative infection, as well as 100 mg of the anti-in- Fig. 5a–d_Sequence using the 4.0 mm expander. Fig. 6a & b_Prepared bed showing vestibular wall expansion. Fig. 7a–d_Placement of the implant with the same conical form of the instrument. Fig. 8_After suturing, an increase in the volume of gingival mucosa was detected (green arrow). Figs. 9a & b_Clinical (a) and radiographic control (b) after ten days. An increase in the volume of gingival mucosa was detected (green arrow). I 27implants2_2012 Fig. 5a Fig. 5c Fig. 6a Fig. 7a Fig. 7c Fig. 5b Fig. 5d Fig. 6b Fig. 7b Fig. 7d Fig. 8 Fig. 9a Fig. 9b