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

• 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.

Treatment

1. Extract the tooth.
2. Debride the socket with an ultrasonic scaler (Fig. 3).
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.
4. Use a 4-step sequence with progressive drill sizes to drill the implant hole (Fig. 5).
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.
6. Install the impression sleeve on the implant/abutment (Fig 9).
7. Index the impression sleeve on the adjacent teeth (Fig. 10) for transfer to the model.
8. Prep the model to receive the indexed analog (Fig 11).
9. 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/).
10. Seat the pre-machined sleeve on the abutment (Fig. 14). The sleeve serves as the crown substructure.
11. The lab-fabricated crown shell is seated on the abutment, where it is finished on the model.
12. The finished crown can now be placed in full function (Fig. 15). Fig. 16 is oneweek post-operative.

Clinical study

  Download the Original Article 536.20 Kb