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Head of the implant deeply buried - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are -
From: Guy W. Moorman, Jr. D.D.s.
Sent: Thursday, August 24, 2006 5:00 PM
Subject: [roots] An interesting one

88 year old gentleman who is now a bit confused but still here.  
He was brought in by his daughter.  Try to get past the implant 
because it is ten years old and functioning fine.  I think the 
problem was that the head of the implant was buried so deeply 
that there was either tissue between the transfer analogue or 
it moved up during cementation due to extremely fibrous tissue.  
I can't probe the open margin even with a perio probe so tissue 
has filled the open margin.  It's working like a champ...mesial 
abutment of a three unit bridge.

But the story was this patient of mine took her father to the 
endodontist in Jacksonville he'd used before with #8 hotter
than a fresh fired pistol ball from her description.  
The endodontist half accessed it and told them the canals were
calcified and he needed another implant.  She brought him to me 
since I've done a couple of endos on her.  It wasn't a
piece of cake but the canal wasn't massively difficult to find.  
Once found it opened to an F3 ProTaper and finished to a
45 apex.  He reports that he fell on this tooth when he was six 
years old while roller skating.  I'm suspicious that there is a 
fracture right at the defect that filled in and that little puff 
is from that fracture and not a lateral. I think the tooth is 
ankylosed and extracting it would be a bitch.  I filled the canal 
with Epiphany/Resilon using System A.  This proves that not all 
endodontists are of the same quality AND never diagnose solely 
from a radiograph - Guy

Nice save Guy! As for that implant it appears it was placed sub crestal and the system was not designed to be placed that way. Definitely a gap and its surprising it has not created any issues to date - Arturo At his age, it had better hurry. Guy so why did he need a root canal? - ahmad Irreversible pulpitis. Severe sensitivity to hot requiring cold to relieve it. You have to fight these people for their cup of ice. Guy Guy, Don't stop. I do like your post - John Anderson

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