Opposite to teeth, whose surrounding bone receives plenty of blood support from the periodontal ligament, the implant have no ligament and no surrounding blood circulation. Thus the buccal wall blood support comes only from the periosteum and the transeptal blood vessels.
Providing the buccal bone wall with a good thickness allows the internal bone blood vessels to supply nutrients to the buccal bone.
|protecting the buccal bone wall|
|with bone graft and membrane|
The width of the buccal wall of a dental implant is becoming more and more important for its long term durability.
Placing the dental implant with 1,5 to 2 milimeters away from the buccal wall provides the bone wall with enough blood supply.
The X-ray shows two edentulous spaces on a 60 year-old man, non-smoker. Thick biotype.
Preoperatory diagnostic measures. Control of the soft tissue quantity and quality
as well as a2D X-ray measurement with 5″ diameter balls.
- Implant placement surgery
Regular split flap with only one vertical discharge mesial of the spot.
The 3,75×12,5″ ICX-Templa
nt (internal hexagon) dental implant is placed 1mm under the bone level. This allows some typical crestal bone resorption while still keeping the internal cone properties of the implant. Notice the concavity of the buccal wall under the ridge level.
Bio-Oss and Bio-Guide GBR material protecting the buccal bone wall. This increases the initial volume and adds extra hard tissue substance to the buccal wall.
Panoramic post-operatory X-ray, after placing two 3,75×12,5″ ICX-Templant internal hexagon dental implants.
Suture of the flap with 4/0 Prolene.
healing sequence after 2 weeks,
and after and 9 weeks
- Implant exposure surgery
after 8 weeks a partial thickness displacement flap is moved buccally, with the incision beginning well on the lingual side, The keratinized tissue is displaced buccally. 6″ Healing abutment over the 3,75×12,5″ ICX-Templant (internal hexagon)
3 weeks after the exposure surgery, with the healing abutment.
- Prosthetical phase
Impression transfer for a closed tray.
3,75×12,5″ ICX-Templant (internal hexagon) abutment on cast lab model showing the platform switch, with the corresponding crown
Soft tissue 6 weeks after the implant exposure surgery. 6″ healing abutment.
3,75×12,5″ ICX-Templant (internal hexagon) abutment emerging. Screwed at 30Ncm torque.
Metal-ceramic crown placed on the 3,75×12,5″ ICX-Templant (internal hexagon) abutment. Notice the metal line at the gum level, due to slight gingival retraction
Soft tissue 12 weeks after the implant exposure surgery, 6 weeks after crown placement.