Immediate Placement of Bicon Implants in Molar Extraction Sites

Hi. I’m Drauseo Speratti, and thanks for the opportunity to talk to you again. As you may know, Bicon has a very good technical support, and when clinicians have questions about treatment plan or surgical procedures or restorative procedures, you can always contact us by phone, email, or through the website. One of the most often asked questions is about immediate placement of implants after molar extraction. As you may know, many clinicians have different techniques, different tips on how to do it, and experienced surgeon may give you different ways to do the same procedure. The idea for us on this video is just to illustrate some simple ways of placing of these implants after molar extractions and especially for those you’re doing for the first time. For lower molars, we usually recommend aiming the pilot drill, the tip of the pilot drill directly into the septum area right on the center of the socket. The idea is to establish the proper direction and the depth of the osteotomy. Once I’ve done this procedure, we start using the latch reamers. The latch reamers will prepare and widen the osteotomy. Once we reach wider diameters of the latch reamers, this septum bone will collapse and form one of the walls that will stabilize the implant. The other socket walls will stabilize the implants as well. Once we finish osteotomy preparation, we recommend placing a wider implant. Usually, a six by six is the recommended one. In order to try to fill the socket as much as we can. These sockets are usually very wide. Even though we’re using a wide implant, we’ll not be able to fill the entire socket. So if you harvest any bone during the osteotomy preparation, you may use the bone to fill the voids. If not, feel free to use any bone grafting material like SynthoGraft, for example. The idea is to protect all the areas of the implant and the socket not to be exposed. On the top of that, we should use a collagen plug. The function of the plug is to provide protection to the implant and the grafting material underneath. Also, allowing after the suture for a healing of the soft tissue by secondary intention. Some clinicians prefer instead of using the collagen plug to make some surgical procedures or surgical maneuvers in order to stretch the soft tissue and achieve primary closure. This usually takes a lot of time and requires very good knowledge of surgical procedures. For the upper implants, the procedure is very similar. However, we must take into consideration the anatomy. Keep in mind, the molars, the upper molars, they have three roots. So the surgical technique, you start as well with the pilot drill, aiming at the center of the socket or the center of the septum area between the roots, the small inclination towards the palatal root. Once you reach the proper depth and direction of the osteotomy, we start using the reamers, either the latch reamers or the hand reamers as you prefer. The septum bone also shall collapse and will form a wall to stabilize the implants in conjunction of the palatal root socket walls stabilizing the implants on the ideal position. Once you finish the osteotomy preparation, you fill the voids with harvested bone or bone grafting material as we mentioned before. Using a collagen plug, also protect the socket, suture, and have the implants there stable and protect surrounded by bone grafting material. Keep in mind that the septum bone very often is very pointed or sharp. So prior to the initial osteotomy procedure with the pilot drills, we should flatten the septum bone in order to have a good starting point with the pilot drills. Hope you’ve enjoyed this presentation. For more information, please visit the Bicon dot com website or give us a call or send us an email. Thanks for watching.