Case Studies
Teeth in One Day! With ICP Implant
Dr Firdaus Hanapiah
BDS(Otago) MSc(Lon.) FDSRCS(Eng.)
Introduction
The advent of dental implant has made it possible for patient to liberate themselves of conventional crown and bridges as well as removable dentures. However, implant treatment has its inherent disadvantages as well. Since conventional implants will need some time for it to osseo-integrate, these conventional implants will need to be protected from the everyday occlusion. Therefore dentures or temporary Maryland Bridge will be a natural solution for these cases. Most of the time, it will mean dentures, which could be the very least annoying to the patient or at worst, a social embarrassment for them.
The Alternative System
The one piece dental implant would be ideal in this case. However choosing the right type of implant as well as careful case selection is paramount in insuring a successful outcome. The implant system must give good primary stability as well as easy to restore immediately after surgery. The advantage of a one piece implants is that it has no interface between the abutment and the main fixture, therefore this will eliminate the problem of micro-gap an screw loosening of the implant, The argument of biological width and wether to have “platform switching” procedure will disappear. However there are inherent disadvantages which will be discussed later.
A Case Report
A 36 year old female who came to our clinic from overseas needed implants to restore to missing teeth on the right upper quadrant. There was a residual tooth still left in the second premolar region.
An impression was made of her upper and lower teeth and was poured in stone. Two teeth were waxed up where the proposed implantation should be.
Surgical Phase
On the day of surgery, the patient was prepped accordingly. Local anesthetic was given, and the root of the second premolar was promptly removed. A flapless surgery was decided as the best option and the patient . Two single stage one piece implants (ICP Implant, Turin, Italy) were placed with no mucosal flap raised. The advantage of this procedure is that there is:
1. No periosteum is raised therefore post-operative pain is at its minimum
2. Less bleeding
The implant abutment is then prepared like any normal crown. Note the picture above (Fig 3) was taken not more than 20 minutes after the implants were surgically placed. What is notably missing is any form of bleeding from the op site.
The new implants were promptly radiographed to make sure that it is properly placed and no vital structures have been breached.
Note that the implants were placed nicely in the space available. Care is taken not to interfere with adjacent root of teeth or the sinus space above
Prosthetic Phase
A silicone impression was taken of the waxed up model to make a provisional crown of the above case.
The silicone impression was then placed back into the mouth to be fitted into the occlusion with a temporization material (Protemp, 3M, USA)
The temporized crowns were adjusted to the occlusion as well polished to a fine finish.
The patient was then given appropriate antibiotics and analgesics and was sent home with provisional teeth placed on the newly placed implants.