1- Extract tooth as atraumatically as possible.

Note: Use of periotomes Recommended.

2- All fibrous and cystic tissue must be curetted.

Note: Use of Ultrasonic Scaler and Laser for Socket Disinfection recommended.

3- Use the Rosette drill to make an initial notch on the palatal wall of the socket.

Note: The shallower the palate, the more coronal position of the notch.

4- Use the pilot drill to penetrate the palatal wall of the socket through the initial notch.

Initially (A) enter at slight angle and then (B) upright the drill to match the direction of the socket.

Note: Since all anterior teeth that are replacedwith a 13 or 16 mm implant for immediate loading, the pilot drill is always inserted to its hub.

Warning: After initial penetration through the notch the drill must drop down easily through the spongy bone. If it feels like you are going through hard bone you are possibly perforating through the palate. Upright your drill further.

5- Follow the initial pilot drill path with the guide drill

6- Use your final drill to go to the desired length.

Note: The IC implant has a 2mm collar in addition to the implant length. Drill 20 mm for 16 mm implant & 17 mm for a 13 mm implant from soft tissue level.

7- Taper your preparation with the proper finishing drill.

Note: This step is necessary in type I or II bone. In tooth sockets, this is done to make space for the head of the implant, only if necessary.

8- The implant is self tapped in the preparation by using either a hand piece or ratchet.

Note: Drive the implant to the desired level. 2 mm subgingival is recommended.

9- Expand the implant by using the Sargon screw driver to 17-20 N/cm2 of torque.

Note: you can use a torque-wrench for this step. Sargon screw driver is designed to distort prior to any damage to the internal screw.

Restorative Steps For Sargon Immediate tooth replacement

  Laboratory Steps

When the patient is initially seen a diagnostic model and shade of the tooth being replaced is taken and send to the lab.

1- A diagnostic wax up is fabricated.

2- An Estenia (Hybrid Porcelain by Kuraray) crown shell and an acrylic positioning jig is fabricated and sent to the Dr..

3- A work model is made by hollowing the tooth being implanted and seating the indexed analog

4- Cold cure acrylic is used to secure the analog to the model.

5- A premachined crown-sleeve is opaqued and placed on the abutment

6- Use the jig to secure the crown shell on the sleeve by using light cured composite.

7- Remove the crown and sleeve and finish contouring by adding additional material.

8- The fully contoured crown is then light and heat cured.

9- Final contouring and polishing is done.

10- The finished crown is taken for immediate delivery to the patient.

Finished Crown on the Model.

                                               Clinical Case