4-Dimensional Implant Dentistry- Implant Replacement of Lower Premolar

Case report

This patient had a non-restorable lower premolar with a vertical root fracture which had to be extracted. The site was grafted and allowed to heal for 4 months. A dental implant was precisely placed following total digital workflow and then restored with perfect crown contours, fit, and bite. This is what we call 4-dimensional dentistry- what patient love.


  1. Atraumatic tooth extraction
  2. Site bone graft to preserve tissue
  3. 3-D computer-assisted planning
  4. Surgical guide fabricated from 3-D work up using 3-D printing
  5. Selected dental implant placed using the surgical guide.
  6. Following 4 months of healing, a custom abutment and crown were fabricated and placed.

Success factors

  1. The diagnostic work up began with the end in mind.
  2. 3-D digital work flow for diagnostics and planning
  3. A proper surgical guide allowed accurate placement of the implant.
  4. Site development with soft tissue development allowing proper tissue topography and emergence.
  5. Well-designed and fabricated implant restoration


4-Dimensional Implant Dentistry Using Digital Workflow from H. Ryan Kazemi, DMD on Vimeo.