Management of Compromised Extraction sites

109 Rating(s).


Posted on By Alexandra Tsigarida In Anterior/Esthetic

46 y.o. Female, ASA1, currently in pain on #8. Patient is on antibiotics (provided by her general dentist and endodontist) for the last few weeks
Presents w/ FDP #8-10.
Both abutments are failing.
#8: fistula present on the mid buccal, buccal and palatal bone compromised.
#10: Periapical radiolucency and based on the overall analysis of the CBCT an apical fenestration is also present.
High smile line.
The initial plan is to place 2 implants on sites #9 and #10 and cantilever 8. How would you approach the case in order to avoid having the tissue collapse especially on #8 site?

Anterior View
High Smile Line

CBCT 8
CBCT 10


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1 Comments

Alexandra; I would consider this case a high risk. Many challenges and considering the high lipline a case requiring advanced surgical skills. My first impression is to evaluate tooth #10 for endo treatment by endodontist. If the current bridge is stable, I would then consider re-eval and possible apico on #8 after consult with a good endodontic colleague. Only after that has been exhausted would I consider removal and replacement. The case would require bone and soft tissue augmentation and I would prefer implants segregated and placed in area of #8 and #10 or if #10 can be saved thru endo then implants #8 & #9. Good luck Dr. Salama


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