1. Surgical extraction with Immediate Implant Placement These cases are selected only after careful review and preparation These cases are selected only after careful review and preparation Surgical removal of involved tooth must be atraumatic and free of chronic infection Surgical removal of involved tooth must be atraumatic and free of chronic infection Socket angulation must be considered as well as implant position Socket angulation must be considered as well as implant position All patients are prepared for the potential for delayed, staged treatment All patients are prepared for the potential for delayed, staged treatment

2. Immediate Placement of Tapered Screw Vent Implant into Mandibular Right First Bicuspid Socket

3. Implant Placement Implant inserted into lingual aspect of extraction site Implant inserted into lingual aspect of extraction site Creating slight buccal defect Creating slight buccal defect Buccal defect grafted with mineralized freeze dried bone and platelet rich plasma Buccal defect grafted with mineralized freeze dried bone and platelet rich plasma

4. Final Implant Position Implant is secure and stabilized Implant is secure and stabilized Graft material localized and contained Graft material localized and contained Mucosa prepared for closure Mucosa prepared for closure

5. Surgical Uncovering and Prosthetic Phase Surgical exposure at time of uncovering is minimized Surgical exposure at time of uncovering is minimized Placement of Zimmer contoured abutment Placement of Zimmer contoured abutment Fixture secure and abutment torqued to 30 nw/cm Fixture secure and abutment torqued to 30 nw/cm

6. Case prepared for Restorative Colleague and Temporization Case was uncovered 10 weeks after extraction and implant placement Case was uncovered 10 weeks after extraction and implant placement Implant was temporized out of function for 20 weeks prior to final restoration Implant was temporized out of function for 20 weeks prior to final restoration

7. Tapered Screw Vent Implant (Zimmer, Inc.) with Contoured Abutment Abutment and restorative kit comes complete with: Abutment and restorative kit comes complete with: 1. Temporary coping 2. Transfer coping 3. Burnout coping 4. Transfer pin

8. Temporary Coping Allows for easy and accurate temporization Allows for easy and accurate temporization Protects contoured abutment and oral tissues between surgical and restorative appointments Protects contoured abutment and oral tissues between surgical and restorative appointments

9. Immediate Replacement of Maxillary Right Central Incisor Recently fractured non-restorable central incisor Recently fractured non-restorable central incisor Atraumatic removal of involved tooth Atraumatic removal of involved tooth

10. Implant Placement Osteotomy site prepared Osteotomy site prepared Implant and impression post stabilized Implant and impression post stabilized Notice slight buccal defect, this defect is often present and can be treated at the time of implant placement Notice slight buccal defect, this defect is often present and can be treated at the time of implant placement

11. Final Preparation Temporary coping placed Temporary coping placed Small buccal defect grafted with autogenous cancellous bone from osteotomy site Small buccal defect grafted with autogenous cancellous bone from osteotomy site

12. Ready for Temporization Conservative flap margins closed over graft Conservative flap margins closed over graft Good buccal contour maintained Good buccal contour maintained Temporized same day by Restorative Colleague Temporized same day by Restorative Colleague

13. Same Day Result This treatment was all accomplished in the same day with the cooperation of our restorative colleague This treatment was all accomplished in the same day with the cooperation of our restorative colleague Notice how the temporary restoration is prepared totally out of function for 4 months Notice how the temporary restoration is prepared totally out of function for 4 months Final prosthetic restoration is planned for 4 months later Final prosthetic restoration is planned for 4 months later

14. Less then 4 hours beginning to temporization