Implant Placement at #47 with Limited Access Due to Restricted Mouth Opening
Surgical Procedure
Chief Complaint
Missing lower right second molar (#47) requiring implant replacement.
Clinical Findings
Edentulous #47 site
CBCT showed adequate bone for implant placement
Limited mouth opening noted, posing challenges for access and bone preparation
Soft tissue stretch-related tearing risk explained to patient
Treatment Plan
Implant placement at #47
Autogenous bone harvesting for augmentation
Soft-tissue management and primary closure
Post-operative CBCT verification
Pre-operative Assessment
CBCT reviewed
Implant position planned
Patient informed of limited access and potential complications (soft tissue tears, limited visibility, restricted drill angulation)
Risks and procedural details explained
Patient understood and agreed
Informed consent obtained for implant placement at #47
Anesthesia
Local anesthesia.
Surgical Procedure
Patient cleaned and draped
Incision made; buccal flap raised
Implant osteotomy prepared with drills despite limited access
Autogenous bone harvested during site preparation
Megagen AnyOne Implant (5.0 × 7.0 mm) placed
Bone profiled around implant
Dentium healing abutment 6.5 mm (M) placed
Buccal autogenous bone chips applied around healing abutment
Flap released and sutured
BSS × 2 placed for primary closure
Hemostasis achieved; POI given
Post-operative Assessment
Post-op CBCT confirmed good implant angulation and position
IDN not involved
Patient satisfied with outcome