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Should I place an implant for my patient?
Posted on 10.31.2012 06:41 PM
By TRI DUNG NGUYEN
In Implants
Dear my colleagues,
My patient: male, 35 years old, good general health, no smoking.
He lost tooth 11, 12 (right central and lateral incisor) over 15 years. He’s wearing a partial removable denture. It’s OK now, but he wants to place an implant there. The prosthesis space is now only suitable for 01 tooth. Because of the bone loss, there’s a fake gum at buccal wall.
The smile line is low (gummy smile).
Occlusion : cross bite, cannot make the same size for tooth 11 and 21 (see my picture).
My questions are :
- Should I place implant for him? The most worry is esthetic complication. Maybe the last result with bone graft, gingival graft also cannot prevent a black triangle space (because of the loss of dental papillae). I can’t imagine the last result in this case, a low smile line and cross bite patient. Is it acceptable? Can I use the pink porcelain to manage this case?
- In case of implantation, how should I do? Implant with GBR with bioss and collagen membrane at buccal wall or should I do the bone splitting technique for better and more predictable result. Is there a high risk for splitting technique?
Thank you very much for your comments.
Best regards,
Dr. Tri Dung.

















4 Comments
Maurice Salama says on 11.01.2012 09:29 AM
No ridge splitting here...GBR with or without implant placement. Add Autologous CTG to reconstitute the gingiva.
good luck
Dr. Salama
TRI DUNG NGUYEN says on 11.01.2012 11:19 AM
Thank you Dr. Salama. According to your experience, this case is not so difficult to get the acceptable esthetic outcome, isn't this? Do you recommend a 3 unit bridge?
Looking forward to hearing from you soon.
Best regards,
Dr. Tri Dung.
Maurice Salama says on 11.01.2012 01:41 PM
No. I do believe that this can be treated successfully with implants. I would be more concerned about the occlusion.
Dr. Salama
Refaat Hassan says on 11.02.2012 10:29 PM
If you at not going to correct the cross bite .no implant , not even a bridge