Dr. Joseph Sarkissian used the Galileos CBCT to plan the oral surgery. He used the metal-free Swiss-made ZERAMEX P6 Zirconia Dental Implant and gym displacement procedure. He wrapped some loose PRF soaked in ozonated saline around the Zirconia implant for faster healing.

Posterior ZERAMEX® zirconia implants guided surgery in no time! The case will be done under IV Sedation by Dr. Luis A Alicea.

ZERAMEX® P6 implants in site # 46-47 to replace failed endodontically treated teeth. The crowns are veneered zirconia – screwed in with VICARBO® Carbon Fiber Screws – 100% metal-free and cement free!

Basically this is a very good example of using ZERAMEX® P6 to replace infected posterior teeth. This lady was aware of the issues with titanium implants and had heard about ceramic implants. With ZERAMEX® P6 I was able to provide a solution superior to titanium from an aesthetic and biological point of view. The infected teeth were remove surgically with advanced extraction therapy, including MP3 and Mucograft. The implants were inserted 6 months later and then restored about 3 months later. The patient did not need to wear a protective splint because P6 is a two-part system. With the VICARBO® screw there is no metal and no cement and it is totally reversible, if necessary. Basically all the flexibility of a titanium implant system without the negative aspects.

This case documents a delayed placement of 2 ZERAMEX XT 5.5x10mm implants followed by immediate fixture level impressions and placement of healing caps. The patient traveled 2.5 hours to my office 4 weeks prior for removal of #19 and #30 with diagnosis of non-restorable and failed root canals. The teeth were extracted and grafted with platelet rich fibrin.

Patient arrived the day of implant surgery and modified osteotomies were performed in the delayed sites with no elevation of flaps. The implants were placed with ease achieving primary stability of 45Ncm. Fixture level impressions were taken the day of surgery and healing caps placed. The patient returned in 3.5 months for delivery of final crowns.

Patient had a defect in porcelain fused to metal (PFM) bridge restoration 11 (23) to 13 (25) and wanted individual teeth again due to difficulty keeping the area clean. Also, patient experienced pain on tooth #14 (26) due to reinfection of failing root canal.  Pain and infection persisting for restore for more than 1 year.

The Endodontist Specialist recommend root canal re-treatment. The patient does not want re-treatment. The patient consented for zirconia implant to be placed at #12 (24), and extraction of tooth #14 (26) with bone graft for future implant restoration. The digital treatment evaluation was conducted with Scanora 3DX CBCT, Trios 3 Intraoral scan and the ZERAMEX files in 3Shape Implant studio. Formlabs 2 3D printer was employed for printing of a surgical guide.

PFM bridge, amalgam build up and decay (cavity) were removed with SMART (IAOMT) protocol. Decontamination of the teeth with chlorhexidine and ozone. Build up was done with composite build up material and re-prep for crown and bridge restoration. Surgical guide was used to place an all ceramic ZERAMEX XT RP (zirconia implant). To improve the healing process Protein Rich Fibrin (PRF) and primary closure chromic gut sutures were used on area of #12.

The provisional (temporary) bridge was made with Luxatemp for healing purpose. Surgical extraction of tooth #14 (26) was done. The surgical area was decontaminated with surgical curettes, burs, chlorhexidine, normal saline 0.9% & ozone. Surgical Piezo instrument was used for sinus elevation. Sinus and socket graft were done with PRF, B-TCP bone graft Augma Biomaterials USA Inc., Collaplug by Zimmer Biomet & nylon sutures. The case was conducted under IV Sedation by Dr. Luis A Alicea at Your Desired Smile, Tampa, Florida