Dental Implant Placement with Immediate Temporary Crown for Missing Lower Right Second Premolar (#45)
Surgical Procedure
Chief Complaint
Patient presented for replacement of a missing lower right second premolar (#45) with a dental implant.
Clinical Findings
Missing tooth #45.
Pre-operative CBCT performed to evaluate bone volume and identify the position of the Inferior Dental Nerve (IDN).
Implant size, angulation, and restorative position were planned before surgery.
Treatment Plan
CBCT-guided dental implant placement at site #45.
Buccal contour augmentation using autogenous bone harvested during implant site preparation.
Placement of an implant abutment.
Immediate temporary crown.
Post-operative CBCT to verify implant positioning.
Pre-operative Assessment
Pre-operative CBCT was reviewed to assess available bone and map the Inferior Dental Nerve.
The patient was informed of:
The implant placement procedure.
Surgical risks and expected healing process.
Benefits and limitations of immediate temporisation.
The patient understood the treatment plan and provided informed consent.
Anesthesia
Local anaesthesia administered to the surgical site.
Surgical Procedure
The patient was cleaned and draped under sterile protocol.
Crestal incision made and buccal flap elevated.
Implant osteotomy prepared using sequential implant drills and osteotomes.
Autogenous bone generated during osteotomy preparation was collected for grafting.
A 4.5 mm × 8.5 mm Megagen AnyOne implant was prepared using Megagen Plasma Blast and placed at site #45 with satisfactory primary stability.
Harvested autogenous bone was grafted onto the buccal aspect of the implant to optimise ridge contour.
EZ Post abutment was connected and torqued to 30 Ncm.
Flap released and primary closure achieved with two interrupted sutures.
Haemostasis confirmed.
Immediate Temporisation
The implant abutment was temporised.
A temporary crown was fabricated and cemented using temporary cement.
A post-operative CBCT confirmed:
Ideal implant position and angulation.
Inferior Dental Nerve remained uninvolved.
Satisfactory implant alignment.
Post-operative Assessment
Implant demonstrated good primary stability.
Temporary crown was stable and functional.
Post-operative CBCT confirmed accurate implant positioning.
Inferior Dental Nerve remained intact.
Patient was satisfied with the surgical outcome.