Today, I am going to share one of my implant restoration case. Patient has tooth #31 extracted in many years ago. It was recommended to him that implant would be the only good option to restore the tooth. In his case, a bridge cannot be made because he does not have another posterior tooth behind the missing tooth for the bridge.
The patient had the implant placed more than six months ago for the tooth #31 location. Today we took an xray to review the implant and its adjacent bone.
From the Xray radiograph image, I can inspect the condition of the gum and the position of the implant. The condition of bone around the implant seems to be in excellent condition. The bone height around the implant is exactly where it should be. There is no bone recession noted on the xray radiograph. Ideally, the bone height should be at the level of the first screw thread of the implant fixture. Also, the implant is upright and is within good distance from the adjacent tooth. Theoretically, there should be a minimum of 1.5mm of space between the implant and adjacent tooth. Clearly, from the xray, it shows there is a least 2 mm of space in this implant case.
Next, I would review the implant inside patient’s mouth. Currently, the patient has a healing cap placed on top of the implant. This is how it looks like in the mouth.
The tissue around the implant healing cap seems to be normal in appearance. The color and texture of the tissue is normal. The patent confirms feeling fine. No pain or swelling complaint.
With the examination complete, I would proceed to the clinical procedure of taking impression of the impant so that I can use the impression to make the implant crown for the patient. In the current state, the implant still sits with the bone. It serves as the anchor for the implant crown. I would need to find a way to record the position of the implant so that I can make the implant crown correctly to fit on top of the implant fixture. This is how I would begin.
I would take off the implant healing cap. After the cap is removed, this is how the implant fixture sits within the jaw bone.
Then I would insert an impression device called the implant impression coping into the female portion of the implant fixture and tighten it lightly so that it does not move or come off. The height and orientation of the impression coping accurately reflects the position of the implant fixture in the bone. Then I would take a putty impression of the patient”s lower right arch. The impression coping would leave an indentation mark within the impression putty in the impression tray.
I would take this impression to my favorite dental laboratory and the implant crown will be fabricated. When the laboratory finished the implant crown, I would schedule the patient to come for another appointment to have the implant crown inserted. At that time, then I will post a follow up article about how I go about inserting the implant crown. Stay tuned!
For Part 2 of the same topic, Click here.
Written by Daniel Tee, DDS, MS
If you have any questions or want to schedule an appointment, Please call 480-820-6131
Practicing General Dentist in Tempe Arizona
