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The opinions within this web page are not ours. Authors have been credited
for the individual posts and photographs where they are. -

Immediate implant replacement

From: Terry Pannkuk To: 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 donít 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 wasnítí a spinner, placed a cover screw. The sinus was tapped but I didnítí really need to go into it. No grafting. Iíve 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 heís 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

K 3 lightspeed

Crown replacement

Root reinforcement

Vertical root fracture

Periodontal pocket

Cox crapification

Cold sensitivity

Buccal sinus

Nikon 995

Distal canals

Second mesial canal

Narrow escape


Severe curvatures

Unusual resorption

Huge pulpstone

Molar access

Perforation repair

Maxillary molars

Protaper shaping

Pulsing pain

Apical periodontitis

Mesial middle

Isthmus protocol

Fragment beyond apex

Apical trifurcation

Jammed K file

Mesial canals

Irreversible pulpitis

Bicuspid abscess

Sideways molar

Red Dye allergy

Small mirrors

Calcified molar

Extraction and implants

Calcificated central

Internal resorption

Bone lucency

Porcelain inlay

Bone allograft