|
| Home | Credentials | Rembrandt Lumineers | Photo Gallery | Premium Crowns | West Palm Video | Beach Whitening |
 |
 |
Mitchell Pohl DDS Restorative Dentist 2900 N. Military Trail Suite 105 South Florida 33431 561-368-3440 
   |
Immediate Load - Placement Dental ImplantsCracked Bicuspid
This 48 year old female presented with a chief complaint of a cracked tooth. Upon examination it was found that she had fractured the lingual (inside) cusp of her left upper first bicuspid.It was fractured below the gum line to the crest of the bone. The main reason it fractured was the existence of a large amalgam filling which weakened the tooth. Treatment OptionsThe patient had two treatment choices. We could perform root canal therapy, place a post and core, and then do a crown lengthening procedure to expose more tooth structure. Doing so would have required removing some gum tissue and bone. Then place a crown on the tooth.The other option would be to remove the tooth, place an implant and immediately place a temporary crown. The patient opted for an implant and crown. 
Immediate Load Implant CriteriaTo do an immediate load implant, certain criteria have to be met. There has to be adequate bone, a large enough implant needs to be placed, and the implant once placed has to be able to resist at least 40 ncm of force.The temporary crown has to be adjusted so that no forces are placed on it during function. Meeting these criteria allows the bone to grow around the implant (osseointegration). After a period of nine weeks a permanent crown can placed. The following picture sequence demonstrates an ideal situation for an immediate load implant or what I call a Vanity Crown because the patient refused to go out in public with a missing tooth. 
A template was made of the tooth prior to removing the fractured cusp so as to facilitate fabrication of a temporary crown.An important factor in this procedure is to carefully remove the tooth without removing any bone in the process. In this photo, we are using a periotome, a thin instrument, to separate the root from the bone. Preparation of Implant Socket
The first photo in this series of four site-preparation pictures reflects successful removal of the broken bicuspid and all root material. The underlying bone material is assessed to provide an optimal plane for the drilling procedure, thereby creating a solid implant foundation.The remaining boney socket (darker eliptical area) can be seen after the tooth was removed. Socket DrillingThe socket was prepared with sequentially sized bone drills to accept a Nobel Biocare Select 5.0mm x 13mm implant.In this photo the final sized drill bit is being used. Precision Implant PlacementThe implant is placed and tested with a torque wrench to see if it can be displaced with a force of 40 ncm.This implant was proven to be extremely stable. Zirconium AbutmentNext we customized a zirconium abutment and attached it to the implant with a torque of 35 ncm.One of the advantages of using a white zirconium abutment as opposed to the silver colored titanium is that there is no graying of the overlying gum tissue. 
X-ray Confirmation: Successful ImplantThis is an immediate post operative x-ray taken showing the implant, zirconium abutment and temporary crown. Note how well centered the implant is between the canine and 2nd bicuspid.The size of the implant and surrounding bone give more than adequate anchorage to place an immediate abutment and temporary crown. Temporary Crown
The last photo shows the fitting of the temporary crown (Vanity Crown) that enables the patient to avoid the "toothless look" she was fearful of.After 9 weeks, osseointegration has been achieved (bone material has completely integrated the implant substance), the permanent porcelain crown will be placed. The porcelain material will be matched precisely with the patient's existing teeth. Future cosmetic considerations for the patient include replacement of old amalgam fillings, all ceramic crowns, porcelain veneers and Zoom teeth whitening. The use of immediate load or same day implants do have certain requirements. Some patients are recommended for regular implants. Contact Dr. Pohl at (561) 368-3440 or use our convenient Consultation Request to arrange a private consultation to determine if you can be a candidate for this popular procedure. Have a particular question? ..... use our Ask The Dentist form to obtain a prompt response. |
|
|
Home
Testimonial
Photo Gallery
Zoom Whitening
Da Vinci
Bad Veneers
Gum Shaping
Lumineers Implants Bad Bite Occlusion Immediate Load Consultation Ask The Dentist Perio Protect Credentials Palm Beach Cosmetic Dentistry Mitchell Pohl, DDS 2900 N. Military Trail, Suite 105 Florida Coast FL 33431 561-368-3440 West Palm Bch County Dental Consultant at  Powered by DentMedHost.com |