#Esthetics 30. Sep 2017

Use of the Straumann® Bone Level Tapered Implant Ø 2.9 mm in the esthetic zone

A clinical case report by Stefan Hicklin, Jelena Gavric, Vincent Fehmer, and Irena Sailer, Switzerland

Initial situation

A 51-year-old female patient presented herself at the University Clinics of Dental Medicine in Geneva (Division of Fixed Prosthodontics and Biomaterials) in April 2016 complaining of occasional episodes of mild pain in the region of tooth 12. The patient was healthy, a non-smoker and was not taking any medication. During the clinical examination, she complained of mild pain on percussion of tooth 12. The tooth was endodontically treated and restored with a composite build-up (Figs. 1-3). Furthermore, the tooth showed increased grade 2 mobility, and no periodontal probing depth (PPD) exceeded 4mm. The periapical radiograph showed radiolucency around the apex of tooth 12 (Fig. 4).

Treatment planning

After consultation with an endodontic specialist, it was decided to extract tooth 12 and to perform a ridge preservation procedure to maintain the volume. After a healing period of 8 weeks, an early implant placement procedure was planned. A resin-bonded fixed dental prosthesis was also discussed as an alternative treatment option. Since the distance between teeth 11 and 13 was narrow (approximately 6mm), the treatment plan was to place a Straumann® BLT implant with a diameter of 2.9mm (Small CrossFit® connection), including guided bone regeneration if needed. After successful osseointegration and a provisional phase, the implant was planned to be restored with a translucent zirconia (Katana Zirconia, STML A2 T18) crown on a titanium bonding base (Straumann® Variobase®). The plan was to take an analog impression and then follow a digital laboratory workflow using CAD/CAM technology.

Surgical procedure

The tooth was extracted and a xenogenic bone substitute in combination with a punch graft from the palate was used to perform a ridge preservation procedure (Figs. 5, 6). A provisional removable prosthesis was adapted and incorporated to replace the missing tooth.

Related articles