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Blue Curved Tubes
Immediate Placement and Immediate Loading Using Socket Shield Technique

Case Summary 🔎


Patient Information

  • Date: 2022-05-22

  • Patient Information: 68 years old, Male

  • Medical History: Diabetes, Hyperlipidemia, Thyroid disease


Treatment Plan

  • Remove old crown of tooth #13, perform root cutting, and apply the socket shield technique

  • Implant placement using Digital Guide (VAROGuide)

  • VAROGuide initial drilling ▶ Neo Master kit drilling ▶ Maxy kit (Upcoming Release) ▶ IS-II active implant placement

  • Immediate placement and immediate loading with Magic i Temp


Results

  • Product used : IS-II active Ø4.0X13mm (BIS4013A)

  • Bone Quality : D113 (C1M1I3) – CMI Fixation

  • ITV : 40Ncm

  • Immediate loading with Magic i Temp

  • ISTV : 69 (On the Magic i Temp)


Case Presentation


1️⃣ Pre-Op

1) Pre-Op X-ray

Pre-Op X-ray

2) Pre-Op Smile Line & Intraoral Photo


2️⃣ Surgical Plan

  • #13 VAROGuide Implant planning

  • Implant size : 4.0X13.0 / Sleeve offset : 13.5mm



3️⃣ Surgery: Using Socket Shield Technique

1) Crown cutting and Root rest

Crown cutting and Root rest

2) VAROGuide R/W kit Initial drilling, Ø2.2 drilling followed by confirmation of Bone Quality D113 (C1M1I3)

VAROGuide R/W kit Initial drilling, Ø2.2 drilling followed by confirmation of Bone Quality D113 (C1M1I3)

3) Proceeded with Ø3.5 drilling using the VAROGuide R/W Kit according to the drill protocol

Proceeded with Ø3.5 drilling using the VAROGuide R/W Kit according to the drill protocol

4) Used Master kit for additional drilling after Ø3.5 drilling

Used Master kit for additional drilling after Ø3.5 drilling

5) Performed pre-tapping due to hard bone, removed the palatal root, leaving only the buccal root

Performed pre-tapping due to hard bone, removed the palatal root, leaving only the buccal root

6) Implant placement of IS-II active Ø4.0X13mm (BIS4013A)

Implant placement of IS-II active Ø4.0X13mm (BIS4013A)

7) Placement with Buccal Root Shield left in place (Insertion Torque: 40N)

Placement with Buccal Root Shield left in place (Insertion Torque: 40N)

8) Immediate loading using Magic i Temp was performed with appropriate fixation of D113-CMI fixation and 40N

Immediate loading using Magic i Temp was performed with appropriate fixation of D113-CMI fixation and 40N

4️⃣ Post-Op

  • Post-Op Smile line & Intraoral Photo



  • ISTV 69 (On the Magic i Temp)

ISTV 69 (On the Magic i Temp)

  • ISTV measurement reference chart

H.A. Cuff

ISTV

6mm

A+4

5mm

A+2

4mm

A

3mm

A-2

2mm

A-4


5️⃣ Pre-Op PA & Post-Op PA


6️⃣ Post-Op Follow-Up

  • 4 weeks follow-up (ISTV-68)

4 weeks follow-up (ISTV-68)

7️⃣ Results

  • Maintained gingival volume and alveolar bone structure by using the socket shield technique without extracting the buccal root rest, minimizing gingival collapse and surrounding tissue resorption

  • Used the VAROGuide system for initial drill – Ø2.2 drill - Ø3.0 drill - Ø3.5 drilling followed by additional drilling with the Master Kit

  • Confirmed Bone Quality D113 during Ø2.2 drilling

  • Pre-tapping was performed due to hard bone to form threads optimized for the fixture

  • Placed IS-II active Ø4.0X13mm (BIS4013A) implant

  • Achieved appropriate fixation of 40N with CMI fixation at D113 (C1M1I3) without additional bone graft at the canine position

  • Maintained ISTV of 69 at 2 weeks and 68 at 4 weeks, achieving stability with fixation from the remaining buccal tooth

  • Plan for final prosthesis after 3 months


8️⃣ Clinical Video

💡 Discover the detailed surgical process by watching the video below.



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