Implant Placement Surgery at #37 with Buccal Bone Augmentation and Implant Crown Adjustment at #36
SURGICAL PROCEDURE
Chief Complaint
Patient presented for replacement of missing tooth #37 and adjustment/finishing of implant crown at #36.
Clinical Findings
Missing tooth #37 indicated for implant-supported restoration.
Updated pre-operative CBCT taken for surgical planning.
Inferior Dental Nerve (IDN) plotted and confirmed clear of planned implant position.
Adequate bone available with need for buccal augmentation to improve implant support and contour.
Treatment Plan
Implant placement at site #37 using Dentium Superline implant system.
Autogenous bone grafting at the buccal aspect of the implant site to enhance bone contour and support.
Healing abutment placement for soft tissue shaping.
Adjustment and finishing of implant crown at #36.
Pre-operative Assessment
Updated CBCT taken and reviewed.
Implant position planned with reference to IDN location.
Risks and procedures explained.
Patient understood and agreed to proceed.
Informed consent obtained for implant placement at #37.
Anesthesia
Local anaesthetic block administered to left IDN, Lingual Nerve (LN), and Long Buccal Nerve (LBN).
Surgical Procedure
Patient cleaned and draped under sterile conditions.
Incision made slightly lingual to the implant site.
Buccal flap raised.
Sequential implant osteotomy performed using implant drills.
Autogenous bone harvested from the osteotomy site.
Dentium Superline III implant (4.5 mm × 8.0 mm) placed at site #37.
Healing abutment (7.5 mm, M) positioned.
Harvested autogenous bone placed on the buccal aspect of the implant to augment buccal bone contour.
Flap released and keratinized gingiva positioned buccally for improved soft tissue profile.
Primary closure achieved with 4/0 Vicryl sutures ×6.
Hemostasis achieved and post-operative instructions provided.
Post-operative Assessment
Post-operative CBCT taken.
Implant position and alignment confirmed satisfactory.
Inferior Dental Nerve not involved.
Primary closure stable.
Patient satisfied with procedure outcome.