Case Summary 🔎

Patient Information

• Date: 2024-06-19

• Patient Information: 68 years old, Female

• Medical History: None

• Chief Complaint(C.C): Severe pain and mobility in the upper right tooth

Treatment Plan

• Extraction of tooth #16

• Implant placement using Digital Guide (VAROGuide)

• VAROGuide initial drilling ▶ Maxy kit ▶ IT-III implant placement

• Connection of scan body followed by intraoral scan

Results

• Product Used: ITW32 Ø5.0X10mm (ITW325010AP)

• Bone Quality: D2-3 (C2-3M2-3I2-3) – CMI Fixation

• ITV: 40 N/cm

• ISTV: 83

• Connection of scan body followed by intra-oral scan

• Zirconia implant (SCRP type) setting after 4 weeks

Case Presentation

1️⃣ Pre-Op

• Pre-Op X-ray & Intraoral Photo

Pre-Op Panorama

Pre-Op PA

Pre-Op Intraoral Photo

2️⃣ Surgical Plan

• #16 VAROGuide Implant planning

• Implant Size : 5.0X10.0 / Sleeve Offset : 9mm

3️⃣ Surgery

1) #16 extraction

2) VAROGuide placement

3) Using the VAROGuide drill sequence from the initial drill to the Ø4.5 final drill, bone quality at all C, M, I parts was D2-3

4) After Ø2.2 drilling and Ø4.5 drilling

After Ø2.2 drilling

After Ø4.5 drilling

5) Forming the appropriately sized thread for the fixture with pre-tapping(Ø5.0X10mm) by hand

6) Formation of internal threads

7) Flattening the alveolar bone using a denture burr

8) Implant placement of ITW3 Ø5.0 x 10mm (Gingiva cuff 2mm)

9) Implant placement with an ITV of 40N/cm in D2-3 bone quality

10) Bone grafting was performed using Neobone Plus, which is a synthetic bone graft material

11) Connected a Ø7.3X3mm healing abutment, ISTV measured 83 with Anycheck

12) After connecting the scan body, an impression was taken with the i-700 intraoral scanner

Oral Scan Data

4️⃣ Post-Op

• Post-Op Panorama

5️⃣ Post-Op Follow-Up

• At the 2-week follow-up, the ISTV measured 82

• At the 4-week follow-up, the ISTV remained stable at 84, and the final prosthesis was subsequently set

6️⃣ Final Prosthetics: 4-week Early Loading

• The prosthesis was fabricated on the SCRP type, and the contact box was filled with resin

• After intraoral setting, occlusal adjustment was performed, completing the final prosthetics

• After final prosthetics

7️⃣ Final X-ray

• Final Panorama & PA

Final Panorama

Final PA

8️⃣ Results

• Immediate placement of maxillary molar using VAROGuide

• Utilized VAROGuide Initial drill – Ø2.2 drill - Ø3.0 drill - Ø3.5 drill – Ø4.0 drill – Ø4.5 Final drill

• Confirmed bone quality as D2-3 at Ø2.2 drill stage (All C, M, I parts assessed as D2-3)

• Pre-tapping in D2-3, forming threads optimized for the fixture

• IT-III2 Ø5.0X10mm (ITW325010AP) placement

• Additional bone grafting with Neo Bone Plus (Synthetic bone)

• Achieved good fixation with ITV 40N and ISTV 83, followed by scan body connection and impression taking on the same day

• ISTV maintained well at 82 after 2 weeks and 84 after 4 weeks

• 4-week zirconia implant crown setting with early loading