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When a maxillary anterior tooth is traumatized, long-standing chronic inflammation and infection can coexist. Over a period of time, more and more bone loss occurs, possibly due to a root fracture. In this case, the patient was involved in an accident and tooth #9 was partially avulsed. Endodontic therapy was initiated, but over a period of 5 years, the symptoms became worse (i.e. mobility, bleeding, suppuration). The x-ray indicates a possible fracture in the middle third of the root.
An exploratory surgical procedure was then initiated. It was noted that almost the entire buccal plate was missing. It was decided that extraction and implant placement was the best option. The extraction was done atraumatically to preserve as much bone as possible. A one-stage implant was placed at this time also. Even though the buccal plate was missing, there was still enough bone to obtain rigid fixation of the implant. After the implant was placed, a bone graft was placed along with a guided bone regeneration membrane (collagen-resorbable).
The main advantage to placing the implant immediately is the amount of time saved. In this case, the implant was restored 3 months after placement. If the traditional routine were followed, it would have been 6-9 months of wearing an uncomfortable temporary partial denture.
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| Pre-Op | Pre-Op X-Ray |
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| #9 Extracted | |
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| Implant and Bone Graft Placed | Implant Placed, Day of Surgery |
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| Sutured-Occlusal Views | Sutured |
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| 3 Month Post-Surgery; Healing Abutment in Place | 3 Months Post-Surgery; Restorative Abutment in Place |
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| 5 Month X-Ray | Crown Restored |
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