Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-12-06, 11:14:19 | version 1.38.0
| case report demonstrated that the tapered implant offers a better primary stability and the highest insertion torque.9 The thread design is also a major factor in the stability of the implant.10 stability11, which is a crucial factor for immediate loading.12 Therefore, it was decided to perform im- plant placement and immediate loading or immediate temporisation in this case. Clinical case A female patient, 50 years old, presented with a central incisor which had been missing for several years (Fig. 1). The patient was wearing a removable prosthesis to replace the missing tooth. The colour of the tooth had started to change and the patient was not happy with the solution any longer. As the medical questionnaire showed, the patient does not have any systemic diseases. All in all, the patient was in a good general health. The extraoral and the dynamic examination showed a normal opening trajectory with no deviation. The intraoral examination revealed missing teeth in the left posterior mandibular. The patient was wearing also a removable prosthesis. There were some obtu- rations but all in all the oral hygiene was good. The patient’s major complaint concerned the aes- thetic. She wanted to replace the removable prosthe- sis as soon as possible with a fixed tooth. This remov- able prosthesis was an obstacle that disturbed her in her professional and personal life. Fig. 7: Temporary crown. Fig. 8: Two months later: temporary crown was taken out. Figs. 9 & 10: Impression making. The cone beam of the patient showed enough thickness of the bone that allows a high primary After the injection of anaesthetics, the first incision design is very important. It allows to create an inter- dental papilla during the healing phase. Therefore, the incision has to be a concave semilunar incision to- wards the palate (Fig. 2). The implant system chosen in this case was ROOTT Form (TRATE) because of its macro design that allows a high and predictable stability. The system is a self-taping and bone con- densing implant.13 This type of implant can increase the implant stability by increasing the bone density by condensation (Fig. 3). After the drilling (Fig. 4) and implant insertion at 35 N14 (Fig. 5), the implant abutment (Fig. 6) was placed and a temporary crown was done (Fig. 7). The temporary was out of occlusion, its aim was only to restore the aesthetic, to create a good immergence profile and to maintain the new papillae. Two months later, the temporary crown was taken out (Fig. 8) to make an impression (Figs. 9 & 10) and place a final crown (Figs. 11–13). Discussion Immediate loading or immediate temporisation is a well-documented procedure. The Immediate loading of implants in the maxilla is a successful Fig. 7 Fig. 8 Fig. 9 Fig. 10 20 implants 3 2017