Implant Procedure After Extraction: Case of a Man in His 30s

The case I’m introducing today is a male patient who came in for an implant.

As soon as he arrived, he said firmly,

> “Please pull it out right away and do the implant.”

Since he is in his 30s, it was a relatively early age to undergo an implant due to poor tooth care.

Because the tooth had already been causing discomfort for a long time, he seemed to want treatment as quickly as possible.

We immediately took a panoramic X-ray.

The problematic tooth, #46, had come in broken, and he said #47 had already been extracted some time ago because it was in bad condition.

The opposite-side #37 had also been extracted because it was in poor condition. If a tooth is left missing for a long time, the opposing #17 and #27 teeth can move downward, and these already appeared slightly overerupted, so we advised him to proceed with the implant as soon as possible and performed surgery that same day.

Treatment Plan

Although he was still young, the bone width was insufficient, so bone grafting was necessary.

Of course, the patient wanted the surgery to be as minimally invasive as possible.

He chose xenograft for both teeth, and because this case could be completed with a single surgery, we planned a one-stage procedure.

This was a case that proceeded with an implant after extraction, and the bone condition showed dense cancellous bone and thin cortical bone, which is a typical case commonly seen in molars.

For the lower right side, the prosthesis was scheduled to be placed after 2 months, and an appointment was then set immediately for the opposite side as well.

#37 had already been extracted. Here, there was even less bone than expected, so we had to add more bone graft material and proceed.

For that reason, instead of healing abutments after placement, we used cover screws so that the implant could integrate better with the bone.

It seemed like we would need to wait a bit longer here, so we decided to proceed with the second operation 3 months later.

As shown on the X-ray, the lower right #46 and #47 are now in healing mode, so the healing components are visible above the gums.

#37 has a cover screw and is inside the gums, which is why some patients say they cannot see anything in the mouth after placement.

That is why, after surgery, we take another X-ray and explain it once more so we can confirm the success of the procedure with the patient.

Two weeks later, he returned for a follow-up check.

The surgical progress was good, and the gums had healed well.

Week 5: Implant Symptom Check and Cavity Treatment

When he visited again after another 2 weeks, a lot of tartar had accumulated, so we performed scaling.

That day, we also decided to proceed with one of the original treatment plans: treatment for the front teeth, specifically resin treatment on the interproximal surface of the first lower right tooth, #41.

It was not a very large cavity, but since it had been found to be an active cavity, we proceeded with resin restoration.

To create a form for restoring the decayed area, we cleanly removed the cavity with a drill and then shaped the area so the filling material would adhere well.

In cases of deep cavities, we first place a buffering material to protect the area close to the nerve.

The closer it is to the nerve, the more we place a base first and then proceed with resin filling.

After removing the cavity, we filled it with resin.

After that, the shaping process is necessary.

After resin filling, the surface must be refined. It needs to be shaped properly so the teeth connect naturally.

Otherwise, food can easily get stuck, the gums may be irritated, staining can occur, or, most importantly, bite problems can arise.

The polishing process for the filling is a very important step.

Two Months Later: Fixture-Level Impression and Condition Check

He visited the clinic to check the progress.

He did not come only for a follow-up; he also came for a fixture-level impression.

This is an impression method used to accurately capture the position of the implant fixture (the part placed in the bone).

By connecting an impression component to the implant body placed in the bone and taking an impression inside the mouth, the fixture’s position and direction are reproduced.

Using this reference, the prosthesis is fabricated precisely.

We also performed ISQ measurement. This checks how well the implant and bone are attached, and there is a dedicated device for measuring stability.

It uses vibration to assess the stability value, and based on that, we can check the implant’s progress.

We also took a periapical X-ray to examine the surrounding bone in detail and check various conditions.

We confirmed the fixture position, osseointegration status, prosthesis connection, and whether there was any exposure or fracture.

A week later, he came in to have the prosthesis connected.

Implant Crown Placement

At last, after a long treatment process, it was the day to place the implant crown, and I could see the patient’s face brighten.

After attaching the abutments to teeth #46 and #47, the screws are tightened and the zirconia crowns are placed.

After placement, it is necessary to clearly check the bite.

We checked the periodontal ligament once more, then temporarily cemented it and filled the resin access hole.

For tooth #37, we decided to take a CT at the next visit and determine whether a second surgery would be needed.

Second Surgery Performed a Month Later

After taking a CT and reviewing the progress, it was determined that a second surgery would be needed at the next visit.

After checking the CT, we decided to proceed with the second operation at the next visit.

He seemed somewhat disappointed, as he likely wanted the prosthesis to be placed as soon as possible here as well, but after we explained the need to wait in detail, he understood.

After the Second Surgery

After confirming the implant coping connection, we took a fixture-level impression.

One week later, after placing the implant crown prosthesis, we planned to check the progress two months later.

After the prosthetic work was completed, he reported pain on the left side, so we needed to adjust the bite in the #30s area and check whether it improved.

In the #40s area, we checked whether food was getting stuck in the teeth and causing pain.

Sometimes, if a tooth has been missing for a long time and then a tooth is placed, the surrounding or opposing teeth may feel temporarily uncomfortable during chewing.

This is a temporary sensation that can occur because the opposing teeth were missing and then began to bite against something, so there is no need to worry too much.

After adjusting this area, we carried out an additional recheck 2 weeks later.

There were no major issues, and we only scheduled a regular 6-month checkup.

This implant treatment, from extraction to placement, prosthesis fitting, and bite adjustment, was completed over 3 months, which may seem short or long depending on how you look at it.

It takes considerable time and effort to implant and rebuild a single tooth.

Because the patient handled this treatment schedule well, we were able to achieve a good outcome.

With implants, what matters is not only getting them done, but also how well they are maintained, as that can affect their lifespan.

If a tooth is missing, it is not something to casually think, “I can just replace it with an implant,” and leave at that.

We hope you choose a clinic that can provide careful follow-up care as well.

The dental clinic near Sinsa Station does not simply extract a tooth and then do an implant.

We provide diagnosis and treatment that are appropriate for each patient’s current condition.

Implant price, review, and cost in your 20s Where should the implant sequence start?