Lower-left first molar replacement

Clinical case · 01

A long-standing missing mandibular first molar was restored with a single Excellence Series implant and followed through five years.

Patient and presentation

A 36-year-old patient presented with a lower-left first molar that had been extracted years earlier after pain associated with deep caries. The untreated space caused chewing difficulty, and an implant-supported restoration was selected.

Medical review found no reported hypertension, heart disease, diabetes, relevant infectious disease or allergy history. The patient reported smoking approximately ten cigarettes daily and light alcohol use.

Clinical assessment

The opposing and adjacent teeth were recorded as normal. Imaging showed a small amount of vertical bone resorption at the edentulous site, with a deep overbite, tight occlusion and mesial inclination of tooth 37.

The diagnosis was a missing tooth at site 36, with sufficient restorative clearance for implant treatment.

Surgical treatment

An Excellence Series BL.RC4112 implant (Ø4.1 × 12 mm) was placed at site 36 under infiltration anesthesia using an I-shaped incision. A BL.HA.RC6020 healing abutment (Ø6.0, H2) was fitted.

The site was described as Class III bone. No grafting was used. Primary stability was good, reported above 35 Ncm, and postoperative imaging showed favorable position and direction.

Restoration and review

At 14 weeks the implant remained stable with no abnormal peri-implant findings. A cement-retained restoration was completed and periodic reviews were planned.

At the five-year review, the implant remained stable, the surrounding tissues showed no reported abnormality and the prosthetic crown was functioning well.

Stable single-tooth restoration with favorable clinical and radiographic findings at the five-year review.

This case has been edited and reorganized from the original Trusyou clinical record for clearer professional reading.

Clinical information

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