#30 extraction/Immediate Placement/Custom Abutment
This patient presented with #30 crown fractured off with recurrent decay and the tooth could not be saved. We discussed treatment options, he watched our implant videos on treatment options and possible implant treatment. He elected to have an implant placed. After taking the scan and doing the digital waxup it appeared that we could remove the tooth and place the implant immediately. The roots were short and there was adequate bone. I informed the patient that this was possible if all aspects of the procedure went perfectly, ie if the planets align. If not we would remove the tooth and graft the site and wait. I also did a custom healing abutment which I love in this situation as no sutures were required and it helped keep my graft in place, and started shaping the tissue immediately.
This was a motivated compliant patient that I got very good fixation of the implant. It is not often I do molar immediates but felt this was a very good indication.
Ok Just finished this case..
Custom healing abutment removed
Showing gingival 1/3 of final crown and custom healing abutment are the same
final crown
final xray
I was very pleased with the final contours and tissue.
Great case! very inspiring for me since I do not place implants yet, and I am just getting started with the training process. Love the custom healing abutment!
Did you extract the roots after the final osteotomy drill? What did you use to graft after the implant was placed?
On 9/7/2017 at 4:35 am, Douglas Smail, OMFS said...Very nice case! The icing on the cake is the custom healing abutment.
It keeps the graft so well contained, thanks!
Chris and Catherine,
it was a milled Enamic. I could have used teliocad, just like Enamic better. Soon I will be using barons custom healing abutment form that you print out and fill in with composite. Will make this so much faster and cheaper...
On 9/7/2017 at 10:30 am, Dipali Thakker said...Great case! very inspiring for me since I do not place implants yet, and I am just getting started with the training process. Love the custom healing abutment!
Custom healing abutments take it to another level. Get started it's very rewarding. Thanks!
On 9/7/2017 at 1:02 pm, Thad Vincent said... Did you extract the roots after the final osteotomy drill? What did you use to graft after the implant was placed?
Yes, I prepared the final osteotomy and the roots were separated as planned, just as if I had sectioned the tooth. Made for and easy extraction. I used MinerOss corticle cancellous. I get predictable results with it, I am sure many others would work.
On 9/7/2017 at 4:51 pm, Kenneth Magid said... What is the Barons custom healing abutment?
https://www.anatomicprofilegenerator.com/
Dan & Jeff, Thanks, I do love this stuff. It makes my inserts so easy with great final results.
