Failing anterior tooth

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Posted on By bruce birchenough In Anterior/Esthetic

#8 failing due to resorption. My concern is extensive loss of bone both vertically and facially if tooth is extracted. What are thoughts on removing coronal portion of the tooth to below the gingiva/ bone crest and covering the remaining root structure with soft tissue graft creating a submerged root pontic site. I then could cantilever with crown #7/pontic #8 two unit prosthesis?

pa #8
Photo #7,8

Photo 7,8
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4 Comments

I just noticed my own photo that there is substantial tissue loss on the facial #7. Maybe the soft tissue graft could also bulk up that area at the same time to help protect the implant #7?


Reply

Bruce; GREAT post and a very significant dilemma if not handled the right way. The RISKS here are significant with bone loss in interproximal area causing a large papilla defect. You need CTG tunnel or VISTA on Implant #7 and PET #8 with Socket Shield or as you suggested Submerged Root Technique and overlying CTG. You need to come take our PET Hands-on course in Las Vegas end of October...regards Mo


Reply

Hi Maurice,

Do you think socket shield will prevent loss of interproximal bone. I have wonderful results with socket shield in maintaining facial tissue architecture but not sure about interproximal crest. I am just thinking of the possibility of L-shaped shield leaving both facial and distal aspect of the root in this case. any experience to share with this..?


Reply

Thanks for the input Mo. Which of the two procedures would be your recommendation and why?


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