Virtual dental expo

Check Page Ranking

Dental tourism
Dental books
Bad breath
Kids caries
Smoking effects
Patient info
Dental Videos
Wisdom tooth
Drugs of choice
Endo tips    Better Endo    Endo abstracts    Endo discussions

 immediate implant #6
The opinions within this web page are not ours.Authors have been credited
for the individual posts where they are. photographs courtesy: Arturo

From: "Arturo R. García D.M.D."
Sent: Monday, October 06, 2008 4:06 AM
Subject: [roots] Ext and immediate implant #6

This patient has some home care and diet issues, is diabetic and has
ignored his mouth for many years.  I can see that he as UAO and think he
has OSA and is regurgitating at night so I have advised to get a sleep
study.  Hopefully that will control his SA and his stomach acid and help
him keep his teeth.  He has decay everywhere and none of it is small.
Lots of cervical and root decay as you can see from the pics and xrays.

He's a big guy, ~ 6'2" and he had a big canine.  I extracted it slowly
(compared to a standard forceps ext) and carefully with a periotome.  I
checked the socket carefully under hign magnification and the buccal plate
was intact.  I placed a 4.5 x 14 mm Ankylos implant by hand.  Obviously I
did not need to use an ostetomy bur :-).  I was worried that I would not
be able to get primary stabilization because of the size of the socket,
but I did.  I placed a DFDB graft w CaSO4 and closed with a long term
membrane and vicryl suture.  I'm sure I will get some more hard and soft
tissue collapse as the area heals.  The pics are from an intra oral camera
and not the best, but its the best I had available.  I have pre ops and 2
week post op pics.  #7 needed a rct,p/c and crown.  For the rct #7 I used
Ghassan's F2 protaper instrumentation technique and obturated with
Resilon/Epiphany Obtura 2 all squirt technique.  I was lucky to be able to
use the temp crown from #7 to make a fixed temp bridge to provide a stable
temp.  With the healing the pontic is becoming hygienic.

Would you have opted in a situation like this to graft #6 and them come
back in 4-6 months and place the fixture then?  Also, in a similar case
would you feel comfortable placing an immediate implant like this working
off of a peri apical xray alone?  peri apical and pano xrays alone?  I
treated this case in the way I feel comfortable doing and also in away I
feel will be successful.  I'm just curious if you would consider it
overkill to routinely get a CT for an immediate case like this?  Or do you
think I was overly agressive?

Arturo R. García D.M.D.

Toughest root canal

Retricted mouth opening

Deep decay

Upper second molar

Open sinus lift

Implant after extraction

Implant # 20

Implant # 30

Irreversible pulpitis

2 step necrotic case


Lesion on MB

Endo perio case

Surgery or implant

Silver point removal

Series of cases

SS reamers and files

Single visit RCT

Ortho resorption

Apico retreatment

Apical perforation

Funky canine

Crown preparation

Two tough molars

Epiphany recall

To squirt or not

Core distal end

MTA miracles

Pain with LR

Instrument removal

3 canals upper Bi

Acute pain

Dental decay

Calcified chamber

Mandibular first molar

Ultrasonic activation


TF and patency

Interim dressing

Huge lesion

Tough distal canal

Debris in pulp chamber

Access and success

Restricted mouth opening

Broken drill fragment

MB2 or lateral

Gutta percha cases

Another calcified

Big Perf

Canals and exit

Dam abuse

Amalgam replacement

Simple MTA case

MTA barrier

Restoration with simile

Immediate implant

Traumatic accident

Lesion on D root

Extract / Implant

Carious exposure