[MULTI_SUB] Immediate Bi implant placement after Extraction of #15 with Caries – Dr. Kim Jaeyoon

Added: 2026-05-21

[00:00:40]Hello, this is Kim Jay Yun from Dental Bean. Today we will extract the severely damaged tooth number 15 caused by carries and fracture and perform immediate implant placement in the area.

[00:00:56]We are slightly luxating the tooth before extraction.

[00:01:00]And if the extraction does not proceed smoothly, sectioning may be required.

[00:01:05]Special care is being taken to avoid damaging the surrounding buckle bone during extraction.

[00:01:12]If this were an anterior tooth, sectioning would be performed toward the palatal side to protect the buckle bone from fracture.

[00:01:20]But since this is a preolar with relatively thick buckle bone, meodistal sectioning is being performed to separate the roots.

[00:01:30]The roots were extracted successfully.

[00:01:33]Any remaining aical region and granulation tissue were thoroughly removed.

[00:01:42]Now through drilling a notch is being created in the root apex area.

[00:01:53]And drilling is continued through that area to check whether the sinus membrane can be felt.

[00:02:00]After additional drilling, a perforation-like sensation was felt once again and the membrane was explored again in that area.

[00:02:12]A diameter 4.5 * 10 mm BI implant is now being placed. Even in preolar cases like this when the apex and sinus are very close the apical bone must be reduced so that the implant slightly protrudes toward the sinus which allows easier achievement of primary stability.

[00:02:32]You can see that the implant has entered the intended position.

[00:02:36]Final depth control is being performed using a torque wrench while checking how much torque is being achieved.

[00:02:44]The ISQ values are approximately 73 and 74 which indicates appropriate stability. After connecting the healing abutment, since the gap distance exceeded 2 mm, alligraph bone was placed. Of course, if the implant had been placed deeper and the gap distance were smaller, bone grafting in preolar areas could sometimes be omitted.

[00:03:08]Since this case is close to a self-containing defect, only alligraph bone was packed into the site.

[00:03:17]A membrane made from the patient's blood is now being packed, but collar tape or similar domestic collagen product could also be used as an alternative.

[00:03:29]After about 1 to two weeks, it will naturally resoft tissue gradually grows into the area to cover the site. A simple figure of eight suture is being performed to gently approximate the soft tissue and stabilize the surgical site rather than completely sealing it.

[00:04:04]The suturing procedure was completed successfully and the surgery was concluded.

[00:04:12]Healing progressed uneventfully and a custom abutment with a zirconia crown was successfully delivered as the final prostthesis.

[00:04:28]If you look at the X-ray on the left, the abutman was not fully connected. If you encounter an X-ray like this, you should carefully reposition the head and reconnect the abutment properly so that as shown in the X-ray on the right, the black line around the 11° tapered connection is no longer visible.

[00:04:48]Confirming complete seating before proceeding further.

[00:04:52]Thank you for listening.