Orthodontic extrusion and implants : Added images of the completed case.

52 Rating(s).


Posted on By narayan tv In Implants

40 year old female with Severe Maxillary anterior bone and soft tissue loss (Central & Lateral incisors) due to Periodontitis, poor restorations and a palatal wire splint, with an aesthetic concern. Dr. Salama inspired orthodontic extrusion, implant placement and flipper provisional.

Pro-op situation
slow extrusion- over 6 months

immediate post extraction implantation in the central incisor sockets . the Lateral sockets were grafted with Bioactive glass putty, as was the jumping distance. Coronal coverage with PRF & Pericyl
Provisional flipper with a gumfit contour.


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14 Comments

Dr.Narayan,
I think this is one of the most minimally invasive and predictable technique to achieve vertical bone and soft tissue levels to place Implants in a right 3D position and give aesthetic results.I think ur treatment planning is spot on.Keep posted the final follow-up on dental XP for us.


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Impressive all the way through. Congrats.
Dr. Salama


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Thank you Dr.Tarun & Dr.Salama. Will post the final restoration when done.


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tnx for your post. why did not insert your implants in lateral side.i think implants in lateral sites give a better papilla in midline. more estethic & more sustain
thanks again. Ali


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Dr. Ali, thanks for your interest.I would have liked to place the implants in the lateral incisor sites, however, there was a labial bone defect on the lateral incisor sockets. I'm not too concerned about a papilla between the centrals, considering these are platform switched implants and if anything, I'm working with a soft tissue excess right now.Time will tell.


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Dr Narayan
This is a really well planned and executed case. The Gingival Zenith and Levels in the end result is quite impressive especially because it has been achieve with minimally invasive non grafting protocols using orthodontics. Hope to see more stuff from you


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Grt result TV, good case


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Dr Narayan
impressive results, i am totally agree in extruding the teeth for leveling the soft tissue in proper position and bring it to a more coronal level.inserting 2dental implants in central incisor positions is an option but i think especially in high lip line patients its more risky.here also another option would be to augment the lateral areas and insert implants in those positions.this impressive results by your work is a true non invasive treatment.
tnx again for sharing, keep posting
Dr Omid Moghaddas


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Thanks for sharing Narayan. No doubt impressive result.
However, I just one to know your ideas guys. Is submerging one root (central incisor) and alternate the implants in central and lateral incisor positions will have a more predictable (long-term) prognosis from pink aesthetic point ?
My concern is the papillae between centrals and laterals.


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Hi Narayan-tissue health looks pretty good-am sure the papilla will grow back to some extent-great work!waiting to see the final result.


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Very nice end results.Well planned and executed.


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Well done! Your use of Orthodontics converted a diseased and compromised Periodontium to a relatively healthy and stable Periodontium. As a result, multiple options of treatment were availible. My first choice would have been SRT 8 and 9 /implants 7 and 10. In my opinion, this approach would provide most for predictably stable bone adjacent to the implants over time. Great case. Chuck


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Nice job Narayan. The gingival zeniths and soft tissue health looks great in the final post op pics.


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Thank you all for your kind words of appreciation. Dr. Moghidass & Dr. Schwimmer, the lateral incisors would have been my first choice of implant position , however, the crestal labiolingual dimension of the sockets were 3.5-4mm with a thin palatal plate and large buccal dehiscence- hence the decision to go into the central sockets.The final prosthesis was delivered after about 4.5 months of screw retained provisionals.Dr. Omar, the advanced periodontal disease was the contraindication for root submergence, even after extrusion.
Narayan


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