The recently developed Straumann BLX implant combines an innovative design with proven surface technology that gives the clinician the possibility of achieving high insertion torque during placement in a fresh extraction socket. The concept of immediate implant placement after extraction provides reduction in the number of surgical interventions and a shorter treatment time.

Nevertheless, one of the shortcomings with immediate implants in replacing maxillary molars is the number of roots, lower bone density and proximity to the maxillary sinus. Conversely, the use of a personalized healing abutment presents the possibility of maintaining the gingival morphology and cervical dimensions of the extracted tooth, thus avoiding the need to re-create the profile with the temporary restoration.

This visual essay, which I authored with my partner Dr. Jack Goldberg from our practice in Mexico City, will walk the reader through the insertion of an immediate implant in a maxillary molar site with the fabrication of a personalized healing abutment.

Figure 1: Patient presented with a fractured maxillary molar with recurrent decay.
Figure 2: The extraction was performed with minimal trauma to the hard and soft tissues.
Figure 3: Initial osteotomy was performed in the inter-dental septum (bone).
Figure 4: The BLX implant has a macro and micro geometry that allows higher insertion torques.
Figure 5: The implant was placed in a position for a future screw retained crown.
Figure 6: A BLX WB 5.5 x 10 mm was inserted with 50 N/cm².
Figure 7: Once the implant was placed the surrounding area of the socket was filled with Bio-Oss Collagen.
Figure 8: A temporary cylinder was inserted and flowable composite was used in order to replicate the existing gingival contour and soft tissue architecture.
Figure 9: Mesial view of the personalized healing abutment after final polishing.
Figure 10: Distal view of the personalized healing abutment after final polishing.
Figure 11: Personalized healing abutment was inserted, and the access was covered with Teflon tape and temporary resin.
Figure 12: Post-op periapical radiograph.

Following this step-by-step technique will provide you with more confidence in your placement of a Straumann BLX implant with a personalized healing abutment fabricated with flowable composite.

Ricardo Mitrani, D.D.S., M.S.D., is a member of Spear Resident Faculty. Dr. Jack Goldberg, D.D.S., M.S., contributed to this article.


Comments

Commenter's Profile Image Joseph D.
September 30th, 2019
Excellent idea for a custom healing abutment.