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Using ISQ for immediate temporization of a maxillary canine with low insertion torque

Clinical case by Dr Barry P. Levin, D.M.D. Diplomate, American Board of Periodontology

Tooth #11 required extraction and immediate replacement.
Following flapless extraction, a 3.6mm x 13.0mm implant was placed with an insertion torque value of 20 Ncm.
ISQ was recorded with a score of 66 with the Osstell device.

Initial ISQ of 66 at time of immediate placement

The procedure was performed with a Dermal Apron Technique.
The temporary restoration was out of occlusal contact with the antagonist, mandibular teeth and the patient was instructed to avoid function for 6 weeks in this area.
At 10 weeks, the provisional crown was removed for follow-up ISQ measurements.

Immediate temporization via Dermal Apron Technique

The second value was ISQ of 73.
This increase demonstrated enhanced secondary stability or osseointegration.

Follow up ISQ at ten weeks of 73

The crown was restored and has been in function for over 4 years without complications.

Final Restoration

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