Page 1

Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant Case Study by: August de Oliveira, DDS This is so old hat I almost didn't post, but haven't done an implant since last week, so here is a step by step walk-through of a very simple, non-guided immediate molar with a 7.0mmD HAcoated Legacy2. I did the RCT/Buildup and CEREC about 8 years ago and now the patient has pain and some swelling in the inter proximal. Found the MB2 all canals obturated to the apex. So I gave the patient a choice. I did not want to do the retreat, as the RCT was good and I just did not think I could improve on it. The patient could either get the retreat/second opinion from endo, or we could just pull it and do an implant. The patient opted for the latter. I had an hour, and I was leaving to board a plane lecture in a few hours and if you have ever been to LA you know it takes a while to get to LAX, so I opted for non-guided as it was pretty cut and dry.


Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant

You all know the deal. Take a surgical 557 to the furcation after leveling the tooth to the gum line. Make the hole big enough for your 2.3mmD pilot. Let the dentin of the roots guide your drill into the bone of the furcation.

2|P a ge


Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant

Take a film and/or picture of the angulation pin in the furcation because, well, it’s just awesome! After confirming you have a good "glide path" for subsequent drills, section the tooth and remove the roots then proceed with the drill sequence. In this case, we are using a 7.0mmD Legacy2 implant so as you may know we drill up to the 5.4mmD drill then go to the very large crestal bone drill to shape the socket.

3|P a ge


Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant

I just like HA-coated for any immediate molar or any D3 or D4 bone. Crazy amounts of stability, I tolerate greater than 50 Ncm when dealing with these as the buccal and palatal plates are just so thick and I need all the stability I can get. Note the very large gap distance around the implant so we know we are going to have to fill that in with some DFDBA and a membrane.

4|P a ge


Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant

Yawn. If you are an IME reader you know the deal by now. Pack your graft, poke a hole in the membrane with the surgical 557 and use a 5.7mmD healing abutment (I love contour healers but they tend to bunch up the membrane). Sutured as tight as I could with gut. Patient will return in about 6 months to restore.

Dr August de Oliveira graduated from dental school in 1997 from the University of Washington and completed his General Practice Residency in Los Angeles in 1998. Dr de Oliveira has been lecturing on 3D technology since 2004, when he started as a CEREC Basic trainer. Since 2008 he has been involved with Implant Direct’s R and D department developing Guided Surgery Software and Hardware and testing their CAD Milled Bars and Substructure Department. Dr de Oliveira has written two books on Implantology: Implants Made Easy and Guided Implantology Made Easy. He has been involved with beta testing Sirona’s Sidexis Program, as well as developing the Opti and CEREC Milled Surgical Guides. Dr de Oliveira lectures nationwide for Sirona on the Galileos Cone Beam system and Sirona Guided Implant Surgery. He also teaches for Implant Direct at their Las Vegas Educational Facility and with the Engel Institute in Charlotte NC. Dr de Oliveira lives and practices in Los Angeles CA.

5|P a ge

Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant  

Drop It Like A Bad Habit: Step by Step Immediate Molar Legacy2 Implant

Read more
Read more
Similar to
Popular now
Just for you