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Immediate implant replacement
From: Terry Pannkuk To: ankylos@rxdentistry.com Sent: Wednesday, May 05, 2010 5:35 AM Subject: Immediate Placement This patient came in with an emergency pulpitis last Friday. The stars and planets were aligned for an immediate implant replacement. I don’t usually place implants this quickly, but in this case the patient was hyper-motivated/prepared. I was able to communicate with the referring dentist over the weekend to find out what implant system he wanted and send him the CT captures with a general plan with models and planned positioning. The fractured tooth was extracted yesterday morning and replaced with an implant. Primary stability was light but it wasn’t’ a spinner, placed a cover screw. The sinus was tapped but I didn’t’ really need to go into it. No grafting. I’ve found that ideal tissue contouring occurs mainly with gentle hard tissue/soft tissue management, less related to particular implant brand/design, especially with these simple, single implant replacements. The buccal plate of bone was protected by decapitating the crown, releasing the PDL with a thin microsurgical scalpel (which I use instead of a periotome), sectioning the root mesiodistally along the fracture line, drilling to the apex through the single root canal system (determined to be a good pilot hole from the CBCT), then gently elevating the lingual half out from the palate side, then simply flicking the remaining buccal half out toward the lingual without putting any pressure on the interseptal/buccal bone. Perfect case indicated for an endodontist not wanting to step on the political toes of an oral surgeon or periodontist. JJJ The logical extension from an endodontic treatment plan was seamless and uncomplicated. I treated the pulpitis with a tincture of titanium and he’s out of pain; more importantly all the appropriate planning and considerations were performed. The only thing you guys are going to complain about is that I used NBC instead of Ankylos.- Terry
