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Pain in the gum

From: Marcela Sent: Thursday, February 15, 2007 1:19 PM To: ROOTS Subject: [roots] Dancing in the gum A 25 years old girl came today with pain in the gum of URQ..... Beautiful baby tooth (URb). Do you think there is enough mesial-distal space to fit an implant without risking the roots next to it?? - Marcela

Marcela: The proper way to evaluate a lateral incisor case is to measure the lateral on the contralateral side and make sure you have the same m/d width in the proposed implant area. The short answer is yes you have enough room for an implant, although often times we need to use a narrow diameter implants, typically 3.3 or even 3mm in diameter. What is often more of a concern is a concavity or undercut on the facial aspect of the area. In other words, make sure you have enough bone thickness b/l, which may be more limiting than the m/d width. Often times site development procedures like ridge splitting or even block grafting is necessary to correct this facial deficiency. An occlusal radiograph can be helpful in diagnosing.- Gary Hi Marcela, How about a Maryland with lava wing - John Valentine Hi John, The patient wants to watch it for the moment, she prefers to wait until it fall down by itself. Yes a Maryland can be an option too, all depend on the patientīs budget - Marcela Marcela, This is going to be close. To be done only by a careful surgeon with experience. Max laterals are typically an easy placement; but this will require someone with the sense to take progress x-rays during the positioning of the pilot drill, just as you should do when going deep to find a calcified canal. : ) - Wes Rampton Thanks Wes. Donīt worry I am not going to fit the implant ;-) the patient wants to wait - Marcela

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