**5.3 Single implant placement in lower jaw with an insufficient vertical and horizontal dimension**

This case is presenting immediate implant placement in the lower jaw in the premolar region with a lack of bone height and width. The patient had complicated extraction of root 44, which led to greater bone loss. Implant placement was carefully planned with the help of a 3D CBCT scan. Since there was a lack of bone height

#### **Figure 11.**

*Implant placement 9 months after bone augmentation- two-phase approach. (A) Teeth 47 and 48 indicated for extraction. (B) Sticky bone. (C) Grafted area. (D) Clinical appearance 9 months after augmentation with sticky bone. (E) OPG view 9 months after augmentation with sticky bone. (F) OPG of the implant inserted into the augmented bone.*

#### **Figure 12.**

*Single implant placement in lower jaw with an insufficient vertical and horizontal dimension. (A) Clinical appearance of the area where the implant should be inserted. (B–D) CBCT planning. (E and F) The implant threads are exposed. (G) Sticky bone. (H–J) Augmentation with sticky bone. (L) Flap repositioned and sutured.*

toward the mental canal, we planned to leave part of the implant not covered by bone and above the crest line. Missing bone was augmented with the help of artificial bone Novocor plus in combination with platelet-rich fibrin creating "sticky bone." The implant used in this case was 3P by BB dental, and later we placed a screw-retained metal-ceramic crown (**Figure 12**).
