Single tooth replacement using dental implant

Patient 50 years age female was referred for a second opinion regarding implant replacement at missing lower right first and second molars sites: (46 & 47). Patient wishes to improve her masticatory efficiency and dislikes the collapsed facial profile at the Lower right jaw line. Implant tooth replacement will improve the check support on lower halt of the right face.


Short Implants: Mandible-Lower Jaw

Minimal vertical bone present above the mandibular nerve. Mandibular nerve limits the amount of vertical height for implant placement.



Patient 50 yrs age female was referred for a second opinion re: implant replacement at missing lower right first and second molars sites: (46 & 47).

Patient wishes to improve her masticatory efficiency and dislikes the collapsed facial profile at the Lower right jaw line. Implant tooth replacement will improve the check support on lower halt of the right face.

Before implant placement we have number options to place implant in this situation;

1. Short implants<7mm, in our case Dr Nalbandian chose 6mm implants
2. Reposition the nerve to the side and place the implant in the basal bone-30% chance of nerve damage, that will cause numbness of the lower lip o the side of implant placement
3. Graft: vertical block of bone: again complex procedure requires intraoral or extra oral donor site (two surgeries for the sake of one) and donor site morbidity is a real risk.
Following considerable discussion re all modalities and risks of implant therapy at this difficult site, decision was made to place short implants, even though we were close to IAN. Healing was uneventful and implant integration after 4 months was uneventful



Direct screw access to the fixture.



Implant crowns prior to final issue. Crowns are splinted for enhanced biomechanical stability and load distribution.

Note how the implant-abutment screw is directed to the implant surface for final screw tightening.

Implants are ideally placed for optimal prosthetic platform.




The opposing teeth are also carefully refined since they have over erupted into the missing teeth sites 46 & 47.

This will also allow correct occlusal height reconstruction of the new implant crowns to reduce step past 45 tooth. This allowed us to get good arch outline.

Occlusal view: before & after issue of two implant supported splinted crowns.



The short implants (4 x6mm) placed at sites 36 & 47have integrated; implant crown is issued. Abutment screw torqued at 32 Ncm and composite placed on the screw access hole.