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Year : 2018  |  Volume : 18  |  Issue : 5  |  Page : 35-36

CRC2: Drill through the tooth technique for lower molar implant placement – A case report

Date of Web Publication31-Oct-2018

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-4052.244656

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How to cite this article:
... CRC2: Drill through the tooth technique for lower molar implant placement – A case report. J Indian Prosthodont Soc 2018;18, Suppl S1:35-6

How to cite this URL:
... CRC2: Drill through the tooth technique for lower molar implant placement – A case report. J Indian Prosthodont Soc [serial online] 2018 [cited 2019 Mar 26];18, Suppl S1:35-6. Available from: http://www.j-ips.org/text.asp?2018/18/5/35/244656

Thakur Smriti Narayan

Department of Prosthodontics, Chitwan Medical College, Bharatpur, Nepal

Introduction. Immediate dental implant placement is not a new technique in dental Implantology. But immediate implant placement in multirooted molars a challenging task due to several reasons, one anatomical limitations of the socket & another reason is to achieve primary stability after ideal placement of the implant along the interradicular septa.The main purpose of this case report is to present a technique of tooth act as a surgical guide for immediate implant placement in multirooted lower molar tooth. In this technique first of all the coronal portion of the tooth is reduced to the level of marginal gingiva, osteotomy has performed using center of the remaining tooth root complex as a guide. The implant site is prepared by engaging the interradicular septa.The roots of Lower molars are removed atraumatically after completing the final osteotomy site. The fixture is placed directly in prepared implant side thus allowing the precise placement with proper angulation.This technique helps the clinicians in ideal implant positioning in immediate implant placement cases and reduces the chance of the slipping drills in mesial or distal root sockets during initial osteotomies.

Case Description. A 26 year old female patient reported to the department of Implantology, Chitwan medical college & Hospital, Bharatpur, Nepal for the restoration right lower first molar teeth. On examination reveals extensively damaged coronal structure & radiographically reveals incomplete obturated canals. On medical examination revealed no significant medical history. The dental team decided to extract the lower right first molar & perform immediate implant placement. The surgical procedure began after taking the written consent. The surgical site was anesthetized with 2% lignocaine with 1:200000 adrenalines. The coronal structure was decoronated the gingival margin with tungsten carbide cylindrical bur. The drilling sequence was completed up to the final drill & the remaining tooth fragments were extracted atraumatically. The osteotomy site was properly irrigated with saline & Chloarhexidene & a DIO 4mm X 11.5 mm implant was placed in the center of the interradicular bone& healing abutment placed over the fixture. The gap between the implant & the bone interface was filled with BIO-OSS graft. At last Platelet rich fibrin membrane was fixed with 3-0 silk suture.

Discussion: This technique has an increased risk of socket morphology alteration so careful & atraumatic tooth extraction should be followed. Researchers have claimed that it is one of the simpler techniques to obtain a correct three dimensional position of the implant.On the other hand the contraindications of this technique are severe periodontal disease, unfavourable root position, fused roots, ankyloses & active infections.

Conclusion: This technique is one of simpler& less expensive technique to place the implant in correct three dimensional positions. But the long term controlled randomized clinical study regarding benefits & limitations of this technique will be required.


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