The Shield - Coronal & Apical Approach -

152 Rating(s).


Posted on By richard martin In Implants

After a hiatus - I decided that a return case should bring in the New Year with some style.
Middle aged female patient with fractured root canal tooth- with apical pathology - you will note previous implant placement and recession -

This case will demonstrate socket shield technique with removal of canal contents - “apicoectomy”. Apical and coronal shield approach and avoidance of mental nerve -
Food for thought


Note RCT & apical findings
file used to remove canal contents


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13 Comments

Final preparation - Implant placement and graft


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Implant in place
Healed site- note volume & tissue health


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Optical scan capture with scan body and occlusion


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Decided to test my analog skills with chair side provisional


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Soft tissue healing - lets analyze

Custom abutment - lets analyze


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Rich,
decisive biologic treatment plan, with beautiful documentation and execution
Great teaching !


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Awesome case Richard! What did you elect open vs closed apical management?


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Chuck,

Thanks for kind words- I opened for better visibility and the ensure that I could remove apical pathology and to visualize the mental nerve.

Cheeers,

Richard

Provisional removal
Custom digital gold hue abutment - screw retained


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Great case...clean surgical and prostho tx. Thnx Mo


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Hi Richard, the SS combined with apicoectomy is a safe treatment option. Here on the Forum we´ve seen many examples. Have no doubt that this treatment will be a success.
Very clean steps and technique, congrats!
Regards
Jorge


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Great come back, Rich.
Good idea to add the apical approach.
Beautiful images!
What was your provisional during osseointegration time, lol
Best regards, see you soon at OSW
Snezi


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David Maurice , Jorge ,
Snjezana thank you for all the kind words

My provisional was staged initially I let it heal and then at eight weeks did a chair side provisional let it sit for a month and then converted to a custom abutment

Cheers,

Richard


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Digital Rich!!!


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Salvin