Pre PET times?

173 Rating(s).


Posted on By Jose Luis Dominguez Mompell In Anterior/Esthetic

Patient that comes to our office asking about the "Grey Colour at her central incisor"
Inmediate Implant placed 10 years ago.
3D position, implant diameter, implant design... It is sure that everything has played a role to get here but, would Socket Shield have prevent (Partially or totally) this situation? Can we get the same results with CTG (Tuber or palatal) than with socket shield?
Please share your thoughts and your treatment plan in this particular case...

Thanks!

Jose L. Mompell
Juan Chao




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7 Comments

There is no remedy for poor implant position.


Reply

You are right Chuck... In our humble opinion, explantation has to be considered as one of the first choices if not the first...

Would you graft at the same time? Block? Mesh? Membrane?

Thanks for your comments my friend!

Regards from Spain

Jose Mompell


Reply

What a great post. Obviously a shame for the patient but it can be repaired and restored. I would remove the implant and graft is a staged approach. Your saving grace is good IHB on adjacent teeth. Remove implant and soft tissue graft to thicken the KT. Wait 3-4 months and return and Bone Graft with Block, plates or GBR....wait 4-6 months and implant placement. good luck and keep us posted Dr. Salama


Reply

I´m glad you find it interesting Maurice! I absolutely agree with you that the implant needs to be removed. And I had almost the same treatment plan as the one you described. Same, although not staged. But when implant was removed and reconstruction was performed she reconsidered the orto treatment...(We proposed the first day..)

So now we have the implant removed, the area grafted (Soft and hard tissue) and orto treatment being conducted.

IHB is one of the most important keys to succed in this case, and I would like to ask our friends in DentalXP, which technique would have they choosen.

Thanks all for your time and comments!

Jose Mompell






Reply

The implant is integrated! Can cuts be made to move the implant palatally?


Reply

You mean move it palatally and graft the bucal area? IMHO that's risky business. I wouldnt consider that a predictable option and I always try to bear in mind that I'm dealing with a central incisor in a 40 year-old lady.

But I love the way you "though outside the box"!! Thanks a lot for your comment!

Have you done that technique you propose?

Jose Mompell


Reply

Hi Pepo, excellent case to show what happens on an immediate case without the SS technique after 4/5 years...a disaster.
Even though, as DR. S said, you have everything to win in this case. IHB is crucial. I sugest, as Dr. S, to do staged approach, first CTG + bone (Khoury if you like) and then the implant.
Please, keep us posted...and tell us your choice.
Regards
Jorge


Reply


BTI
Brasseler