Step By Step Instructions
Immediate full function: One-visit implant placement, final crown in full function.
Following are step-by-step instructions for the single-appointment procedure to place the Sargon Immediate Load Implant in an extraction socket, in full function with a permanent crown.
Internal-connection wide-platform self-tapping implant.
Features
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Proprietary apical expansion feature allows full-function immediate loading at the time of placement, while osseointegration occurs
- Root form design
- Optimal for use in fresh extraction sockets
- Eliminates the need for a provisional while definitive crown is fabricated
- Has a 98% success rate with immediate full-function loading
- While not mandatory, the CO2 laser greatly simplifies socket decontamination
- Estenia hybrid restorative handles like a composite to allow crown shell finishing in the dental office. Its high porcelain content imparts excellent esthetics
Planning
The patient presented with a periapical abscess in tooth No. 9. It was visible as a buccal swelling above the tooth (Fig. 1) and evident in the pre-operative radiograph, which shows previous endodontic treatment (Fig. 2). It was decided to extract the tooth and replace it with an implant. At this consultation appointment, take a preoperative impression for a diagnostic model and determine shade of tooth No. 9. The lab can then fabricate the crown shell. Re-appoint the patient for the one-visit extraction/ implant placement/final crown seating.
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Fig. 1 A periapical abscess on tooth No. 9 is noted visually, by buccal swelling above the tooth |
Fig. 2 and radiographically. |
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Fig. 3 The socket is debrided using an ultrasonic scaler. |
Fig.4The socket is decontaminated with a CO2 laser. |
Treatment
- Extract the tooth.
- Debride the socket with an ultrasonic scaler (Fig. 3).
- Decontaminate the socket using a CO2 laser (DEKA UltraSpeed, www.dekalasers.com) (Fig. 4). Note: Conventional chemical decontamination techniques can be used as well.
- Use a 4-step sequence with progressive drill sizes to drill the implant hole (Fig. 5).
- Place the implant (Fig. 6) and expand it by twisting the internal screw to 18-20 N/cm2 of torque. The expanded implant is illustrated in Fig. 7 and can be seen radiographically in Fig. 8. Note: The amount of expansion is determined by the condition of the bone.
- Install the impression sleeve on the implant/abutment (Fig 9).
- Index the impression sleeve on the adjacent teeth (Fig. 10) for transfer to the model.
- Prep the model to receive the indexed analog (Fig 11).
- Secure the indexed analog on the model with self-curing composite (Fig 12). The model is now ready (Fig. 13) to receive the pre-fabricated crown shell made of Estenia hybrid ceramic (Kuraray America, http://www.kuraray-am.com/).
- Seat the pre-machined sleeve on the abutment (Fig. 14). The sleeve serves as the crown substructure.
- The lab-fabricated crown shell is seated on the abutment, where it is finished on the model.
- The finished crown can now be placed in full function (Fig. 15). Fig. 16 is oneweek post-operative.
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Fig. 5 Progressive drill sizes are used to create the implant hole. |
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