Implant Placement and Immediate Final Rehabilitation

The implants were placed using local anaesthesia (Fig. 71). Following elevation of a crestal split-thick- ness flap, the vestibular muscles were reduced to cre- ate a stable vestibular region (Figs. 72 and 73). To be on the safe side, the left inferior alveolar nerve was exposed and distracted labially prior to implant placement (Fig. 74). Care had to be taken that the housings clicked into place on the ball attachments as the surgical stent was inserted. An appropriate instrument (e.g. a probe, twist drill or round bur) was used to mark the implant position through the tem- plate. After that, the periosteum was removed with a trephine matched to the planned implant diameter (the surgical stent was removed for this step). After the stent was replaced, drills were placed and passed down through the sleeves until the required diame- ter and length were reached. Deeper channels required switching to incrementally longer drills which were lowered until the depth stop was reached (Figs. 75 and 76). EDI Case Studies 17 Fig. 74 Surgical exposure of inferior alveolar nerve (left side). Fig. 72 Crestal incision to elevate a split-thickness flap. Fig. 71 Implant driver, implant mount, Screw Line implant, pilot drill and shaping drills of incremental length (9, 11 and 13 mm). Fig. 73 Partial removal of vestibular muscles. Fig. 75 The shaping drill is inserted into the sleeve. Fig. 76 Shaping drill advanced all the way into the sleeve.