gIDE: Single Implant Placement for Missing Upper Premolar - Surgical Steps (Vol. 3, Issue 2)




based on information we have we can now

decide that in diameter of an implant of

4.3 so regular platform is the

appropriate diameter as we have 8 plus

millimeters in this mesial distal space

the length of the implant will be 13

numbers based on that we have more than

15 months of height based on the CT scan

it's 18 topical anesthetic is used for

the surgical site and local anesthetic

can either be infiltration as used here

or through block anesthetic here local

infiltration aesthetic is used in a

palette on the crystal and buccal the

first incision is applied using a number

15 blade going through the crest then

going through the buckle circular to the

palatal Sall color the other adjacent

tooth going through the bulk buccal

circular and the palate of circular very

precise and care for incisions are made

then elevators are utilized to make a

full thickness flap elevation which will

show the underlying crystal bone a

surgical guide stent is used which has

an opening for a 2 millimeter drill with

the optimal prosthetic position the

drills used with 800 RPM and is guided

through the stent into the optimal

prosthetic position which was chosen by

a pre-surgical Diagnostics then an

extension is added to the two-minute


and is getting into position to the

optimal length of 13 millimeter which is

the final depth for the implant which

was chosen the next drill is a narrow

platform taper drill 3.5 by 13 which has

got it into position to final depth

where you can see here the final depth

of this year to be 13 millimeters for

the next implant placement the regular

platform taper drill used here is a 13

millimeter which has got into final

position again at the crest of bone

an instrument to confirm that bone

osteotomy and the bony walls are intact

and no perforations or anatomical

limitations are there is used then the

implant is picked up with a long shaft

implant driver the implant is pulled out

of its titanium sleeve and then position

in the osteotomy the first torque used

is 20 Newton by centimeter which will

now bring the implant into the position

using the 20 Newton centimeter

at 20 Newton stopped and we're

increasing the torque to 30 Newton and

continuing with the positioning of the

implant the final position of the

implant can be performed with a manual

torque wrench where in this particular


this implant achieved 45 Newton which is

an excellent stability and puts this

patient into a different options of

loading the implant positioned at or

slightly above the crest of bone and

here see I'm showing the internal lobe

of this 4.3 by 13 facing towards the


surrounded by excellent bone


and radiograph is taken to evaluate to

proper placement of the abutment as well

as the proper emergence of the

restoration for more education programs

visit the guide Institute at WWE ten