Dr. Usman Manzoor

Dr. Usman Manzoor Periodontology & Implantology

Fellowship in Periodontology
Fellow ICOI

๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜s ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ โ€” ๐—จ๐—ฝ๐—ฝ๐—ฒ๐—ฟ ๐—ฃ๐—ฟ๐—ฒ๐—บ๐—ผ๐—น๐—ฎ๐—ฟ & ๐— ๐—ผ๐—น๐—ฎ๐—ฟExtraction of a non-restorable maxillary premolar and molar, follow...
14/08/2026

๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜s ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ โ€” ๐—จ๐—ฝ๐—ฝ๐—ฒ๐—ฟ ๐—ฃ๐—ฟ๐—ฒ๐—บ๐—ผ๐—น๐—ฎ๐—ฟ & ๐— ๐—ผ๐—น๐—ฎ๐—ฟ

Extraction of a non-restorable maxillary premolar and molar, followed by immediate implant placement into the fresh sockets.

๐Ÿ“‹ ๐—ž๐—ฒ๐˜† ๐—ฐ๐—น๐—ถ๐—ป๐—ถ๐—ฐ๐—ฎ๐—น ๐—ณ๐—ผ๐—ฐ๐˜‚๐˜€:
โ–ช๏ธ Optimal 3D implant positioning for maximal primary stability, engaging the interradicular septal bone
โ–ช๏ธ Adequate anteroposterior (AP) spread to support a mechanically favorable, well-distributed prosthesis
โ–ช๏ธ Bone graft substitute placed within the residual peri-implant gap to support socket wall integrity and minimize post-extraction ridge collapse
โ–ช๏ธ Positioning calibrated to preserve biologic soft tissue contour and emergence profile
โ–ช๏ธ Restored with a zirconia splinted prosthesis for combined strength and biomechanics

โœ… ๐—ข๐˜‚๐˜๐—ฐ๐—ผ๐—บ๐—ฒ:
Stable implant positioning with harmonious soft tissue contours, supporting a predictable, functional restoration.

This case reflects how precise 3D planning at the time of immediate placement โ€” not just the implant itself โ€” determines long-term stability, load distribution, and esthetic outcome in the posterior maxilla.

๐—–๐—ฎ๐˜€๐—ฒ ๐—ฆ๐—ฒ๐—ฟ๐—ถ๐—ฒ๐˜€: ๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜ ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ โ€” ๐—Ÿ๐—ผ๐˜„๐—ฒ๐—ฟ ๐—”๐—ป๐˜๐—ฒ๐—ฟ๐—ถ๐—ผ๐—ฟ ๐—ฅ๐—ฒ๐—ด๐—ถ๐—ผ๐—ปFour cases, one recurring pattern: periodontally comprom...
11/08/2026

๐—–๐—ฎ๐˜€๐—ฒ ๐—ฆ๐—ฒ๐—ฟ๐—ถ๐—ฒ๐˜€: ๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜ ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ โ€” ๐—Ÿ๐—ผ๐˜„๐—ฒ๐—ฟ ๐—”๐—ป๐˜๐—ฒ๐—ฟ๐—ถ๐—ผ๐—ฟ ๐—ฅ๐—ฒ๐—ด๐—ถ๐—ผ๐—ป

Four cases, one recurring pattern: periodontally compromised mandibular incisors treated with extraction and immediate implants placement.

Why this region fails so often: Salivary glands ducts empty right onto the lingual surfaces of the lower incisors, driving heavy calculus buildup and chronic inflammation when paired with inadequate oral hygiene practice โ€” on top of a thin gingival phenotype and buccal plate often

๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜๐˜€ ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ ๐—ฎ๐˜ ๐—ฃ๐—ฒ๐—ฟ๐—ถ๐—ผ๐—ฑ๐—ผ๐—ป๐˜๐—ฎ๐—น๐—น๐˜† ๐—–๐—ผ๐—บ๐—ฝ๐—ฟ๐—ผ๐—บ๐—ถ๐˜€๐—ฒ๐—ฑ ๐— ๐—ฎ๐˜…๐—ถ๐—น๐—น๐—ฎ๐—ฟ๐˜† ๐—–๐—ฒ๐—ป๐˜๐—ฟ๐—ฎ๐—น ๐—œ๐—ป๐—ฐ๐—ถ๐˜€๐—ผ๐—ฟ๐˜€Patient presented with periodontally...
09/08/2026

๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜๐˜€ ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ ๐—ฎ๐˜ ๐—ฃ๐—ฒ๐—ฟ๐—ถ๐—ผ๐—ฑ๐—ผ๐—ป๐˜๐—ฎ๐—น๐—น๐˜† ๐—–๐—ผ๐—บ๐—ฝ๐—ฟ๐—ผ๐—บ๐—ถ๐˜€๐—ฒ๐—ฑ ๐— ๐—ฎ๐˜…๐—ถ๐—น๐—น๐—ฎ๐—ฟ๐˜† ๐—–๐—ฒ๐—ป๐˜๐—ฟ๐—ฎ๐—น ๐—œ๐—ป๐—ฐ๐—ถ๐˜€๐—ผ๐—ฟ๐˜€

Patient presented with periodontally compromised maxillary central incisors, no longer salvageable due to advanced attachment loss, referred for extraction and implant-based rehabilitation in the esthetic zone.

๐Ÿ“‹ ๐—ง๐—ฟ๐—ฒ๐—ฎ๐˜๐—บ๐—ฒ๐—ป๐˜ ๐—ฝ๐—ฟ๐—ผ๐˜๐—ผ๐—ฐ๐—ผ๐—น:
โ–ช๏ธ Minimally traumatic extractions of the periodontally compromised central incisors, preserving the buccal plate and papillae
โ–ช๏ธ Immediate implant placement into the fresh extraction sockets to maintain ridge architecture and soft tissue contours
โ–ช๏ธ Careful three-dimensional positioning to support an emergence profile suited to the anterior esthetic zone
โ–ช๏ธ Restoration with two individual zirconia crowns on zirconia abutments, chosen for their soft tissue biocompatibility and natural, translucent esthetics

โœ… ๐—ข๐˜‚๐˜๐—ฐ๐—ผ๐—บ๐—ฒ:
Final restorations demonstrate harmonious gingival contours and symmetry, with esthetics and function matching the natural dentition.

This case underscores the value of immediate implant placement in the anterior maxilla when case selection and three-dimensional positioning are precise โ€” preserving hard and soft tissue architecture while delivering a predictable, esthetic outcome.

๐—ฅ๐—ฒ๐—ณ๐—ฒ๐—ฟ๐—ฟ๐—ฒ๐—ฑ ๐—–๐—ฎ๐˜€๐—ฒ: ๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜s ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ ๐˜„๐—ถ๐˜๐—ต ๐—š๐˜‚๐—ถ๐—ฑ๐—ฒ๐—ฑ ๐—•๐—ผ๐—ป๐—ฒ ๐—ฅ๐—ฒ๐—ด๐—ฒ๐—ป๐—ฒ๐—ฟ๐—ฎ๐˜๐—ถ๐—ผ๐—ป (GBR)Patient presented with a broken-down mola...
03/08/2026

๐—ฅ๐—ฒ๐—ณ๐—ฒ๐—ฟ๐—ฟ๐—ฒ๐—ฑ ๐—–๐—ฎ๐˜€๐—ฒ: ๐—œ๐—บ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฎ๐˜๐—ฒ ๐—œ๐—บ๐—ฝ๐—น๐—ฎ๐—ป๐˜s ๐—ฃ๐—น๐—ฎ๐—ฐ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ ๐˜„๐—ถ๐˜๐—ต ๐—š๐˜‚๐—ถ๐—ฑ๐—ฒ๐—ฑ ๐—•๐—ผ๐—ป๐—ฒ ๐—ฅ๐—ฒ๐—ด๐—ฒ๐—ป๐—ฒ๐—ฟ๐—ฎ๐˜๐—ถ๐—ผ๐—ป (GBR)

Patient presented with a broken-down molar and premolar, both associated with large periapical lesions, referred for surgical management and implant rehabilitation.

๐Ÿ“‹ ๐—ง๐—ฟ๐—ฒ๐—ฎ๐˜๐—บ๐—ฒ๐—ป๐˜ ๐—ฝ๐—ฟ๐—ผ๐˜๐—ผ๐—ฐ๐—ผ๐—น:
โ–ช๏ธ Minimally Traumatic extractions of the non-restorable teeth
โ–ช๏ธ Thorough debridement of the periapical lesions to ensure a clean osseous bed
โ–ช๏ธ Immediate implant placement combined with GBR
โ–ช๏ธ Grafting with xenograft and autogenous bone chips harvested from the maxillary tuberosity, for a biologically favorable blend of osteoconductive scaffold and viable bone
โ–ช๏ธ Coverage with a resorbable collagen membrane secured with resorbable sutures
โ–ช๏ธ Tension-free primary closure achieved via periosteal release incisions and double-layer suturing technique using PTFE and Prolene sutures

โœ… ๐—ข๐˜‚๐˜๐—ฐ๐—ผ๐—บ๐—ฒ:
Healing demonstrated adequate alveolar ridge dimensions with good soft tissue quantity and quality โ€” a favorable foundation for long-term implant stability and esthetics.

This case highlights how careful lesion debridement, thoughtful graft material selection, and meticulous soft tissue management come together to convert a compromised extraction site into a predictable implant outcome.

Rebuilding nature, one layer at a time. ๐ŸฆทA severely broken lateral incisor restored using direct composite under strict ...
29/07/2026

Rebuilding nature, one layer at a time. ๐Ÿฆท

A severely broken lateral incisor restored using direct composite under strict rubber dam isolation, following biomimetic principles to recreate both macro-morphology (form, contour, incisal edge) and micro-morphology (surface texture, perikymata, mamelon translucency) of the natural tooth.

Fluorosis-like white spot characterizations were layered in to seamlessly blend the restoration with the patient's existing tooth shade and surface pattern โ€” because true biomimicry means matching not just the color, but the character of the tooth.

Restoring form, not just function. ๐ŸฆทReplacement of a failing/discolored composite restoration with a new direct composit...
28/07/2026

Restoring form, not just function. ๐Ÿฆท

Replacement of a failing/discolored composite restoration with a new direct composite build-up, layered to recreate proper anatomical contours, cuspal morphology, and surface texture โ€” replicating the natural tooth's optical and physical characteristics.

Attention to occlusal anatomy, embrasure form, and line angles ensures the restoration blends seamlessly with the adjacent dentition, both functionally and esthetically.

Immediate premolars replacement.Each case involved extraction of a premolar followed immediately by implant placement, r...
25/07/2026

Immediate premolars replacement.

Each case involved extraction of a premolar followed immediately by implant placement, restored with a screw-retained zirconia crown featuring highly polished subgingival contours.

Immediate placement at premolar sites brings its own set of challenges: achieving primary stability often means engaging bone apical or lateral to a divergent or fused-root extraction socket, frequently with thin septal bone; managing the jumping distance between implant and buccal plate; avoiding fenestration of a thin buccal plate; and controlling any residual periapical pathology at the time of placement. Proximity to adjacent structures โ€” often a distally inclined canine root, and anatomical landmarks such as the maxillary sinus for upper premolars or the mental foramen/inferior alveolar canal for lower premolars โ€” adds another layer of precision required for safe 3D positioning.

This immediate implant workflow minimizes overall treatment time while preserving the extraction site's hard and soft tissue architecture, reducing post-extraction ridge remodeling.

Pre- and post-operative radiographs shown for comparison.

Full mouth rehabilitation: from collapse to function. ๐ŸฆทPatient presented with multiple missing teeth, failing dentition,...
23/07/2026

Full mouth rehabilitation: from collapse to function. ๐Ÿฆท

Patient presented with multiple missing teeth, failing dentition, and complex bite collapse, complicated by soft and hard tissue defects. Treatment involved extractions with immediate implant placement, combined with hard and soft tissue augmentation to rebuild the foundation.

Occlusal rehabilitation was staged through 2 sets of temporary prostheses to guide the occlusion into a stable, functional position before finalizing.

Definitive restoration: a zirconia prosthesis over multi-unit abutments.

Complex cases like this demand a staged, interdisciplinary approach โ€” surgical precision, tissue management, and prosthetic planning working together for a predictable long-term outcome.

2 implants placed immediately after extraction of lower molar and premolar residual roots and a periodontally compromise...
22/07/2026

2 implants placed immediately after extraction of lower molar and premolar residual roots and a periodontally compromised premolar, with thorough debridement of the associated lesions.

A customized healing abutment was placed at the molar site to seal the socket and preserve soft tissue architecture during healing โ€” adequate quality and quantity of soft tissue around an implant is key to long-term peri-implant health and stability.

Final restoration: a screw-retained zirconia fixed bridge over Ti-base abutments with ovate pontic design.

2 implants placed immediately after extraction in the left maxilla, plus a 3rd implant placed at the healed 2nd molar si...
20/07/2026

2 implants placed immediately after extraction in the left maxilla, plus a 3rd implant placed at the healed 2nd molar site โ€” same visit, different biology.

Immediate sites give us a head start on preserving hard and soft tissue architecture; healed sites give us a stable, mature foundation. Precise planning across both made it a smooth, single-appointment case.

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