Author: Prof. Dr. Jéferson Fagundes.
FEMALE PATIENT, 24 YEARS OLD
She attended the office with a dental abscess in the region of elements 25 and 26.
Initial aspect
INITIAL EVALUATION
Tomography revealed a fracture of tooth 26, clinically confirmed. The region of the upper molars usually has little bone height for immediate implantation and sometimes requires the elevation of the maxillary sinus and bone graft to install implants.
TREATMENT PERFORMED
Short (5 mm) implants are a viable and successful alternative, allowing immediate implant placement without bone grafts, and reducing costs and treatment time.
After the anesthetic procedure, tooth 26 was removed and the alveolus underwent curettage. Next, a 4.3 x 5mm Arcsys Short implant was installed in the interradicular bone septum, with a torque of 50 N.cm. The root alveolus was filled with Nanosynt bone substitute (200-500 micron). A PEEK frictional healing abutment was customized with flow resin and installed in the implant to preserve the gingival scaffold and keep the bone biomaterial stable.
After 90 days, the healing abutment was removed from the implant and then a 2 mm Arcsys transmucosal abutment for screw-retained restoration was installed. A provisional crown was installed over the abutment for screw-retained restoration. In the following consultation, the transfer/ molding procedures were started, concluding the rehabilitation with installing a definitive ceramic crown in zirconia. The clinical and radiographic follow-up of this case reveals great peri-implant bone stability and absence of saucerization after four years and six months, probably due to the occlusal balance and stability of the frictional morse taper prosthetic connection.
Short implants in single prosthetic rehabilitation have been an excellent alternative to classical treatments, motivating dentists to adopt them in their clinical routines.
STEP BY STEP
1 | Occlusal fissure
2 | Tomographic images revealing limited bone height
3 | Extraction of tooth 26
4 | Arcsys Short implant (4.3 x 5 mm) installed in the bone septum and concomitant alveolar preservation with Nanosynt
5 | Periapical radiograph of the short implant installed (torque 40 N.cm)
6 | Customized healing abutment installed on the Short implant.
7 | Peri-implant healing after 90 days.
8| P2.0 mm Arcsys abutment for screw-retained restoration installed (note tissue quality of the emergency profile).
9 | Vestibular view of the abutment for screw-retained restoration and gingival contour.
10 | Provisional crown on the Arcsys abutment for screw-retained restoration.
11| Definitive zirconia crown on the Arcsys abutment for screw-retained restoration.
12 | Prosthetic restoration completed.
13 | Initial aspect.
14 | Final result.
