Page 51 - Dental Practice South Asia 18-6

FIG 1A-B: Missing maxillary right first molar FIG 1B

FIG 1C: Deficient 3D bone FIG 2: Short implant of 4.8 × 5 mm placed with flapless osteotom

examination, treatment options available were: fixed partial denture
and an implant-retained restoration/crown; patient agreed with the
implant-retained restoration/crown as this was more predictable
and conservative to teeth and long term solution.
To check for the bone level for implant selection CBCT (cone
beam computed tomography) was done, which showed deficient 3D
bone i.r.t 16. (Figures 1A,B,C)
Looking at the compromised bone level, she was offered treat-
ment options with dental implants and bone augmentation. The
patient refused bone augmentation and chose the option of short
implant placement in the posterior maxilla. After measuring the
bone level clinically and radiographically, it was decided to place a
bone level short implant (4.8 × 5 mm, implantswiss Implant
System) by flapless surgical procedure. (Figure 2) FIG 3: Post-operative OPG
Implant placement was performed under local anaesthesia; a tis-
sue punch was used to perforate the gingival tissue so as to gain by a torque measuring wrench posing good primary stability, paral-
access to bone without elevating the flap. The osteotomy procedure lel to the roots of the adjacent teeth. ISQ measurements were in the
was initiated with a pilot drill at the punch site under copious irri- range of 75-78, a healing abutment was then placed on the implant
gation; the final osteotomy was prepared by sequential drilling. The to facilitate the development of a gingival emergence profile for the
proper angulations and depth of osteotomy were evaluated with a anticipated restoration. Post-operative OPG was taken to check for
depth gauge and radiographs. After the final osteotomy preparation, the placement of the implant. (Figure 3)
implantswiss implant was placed with an insertion torque of 30Ncm Postsurgical instructions were explained to control postoperative

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Dental Practice // November-December 2022 // Vol 18 No 6 51