Treatment Plan for Defect Site following Avulsed tooth #8

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Posted on By bruce birchenough In Anterior/Esthetic

23 y.o. patient lost #8 about 13 years ago due to trauma. He presented to me with a desire to have a long term restorative solution. After viewing his cone beam images our surgeon felt that due to the excessive bone loss and the extremely large incisive canal the bone graft/ implant surgery was extremely high risk for many reasons. What are your thoughts on implant surgery or suggestions for long term restoration that does not involve surgery?

High smile
Cone beam view

ant pa
ant pa


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5 Comments

Bruce, this case can be managed by an experienced surgeon. Good IHB on the adjacent teeth. Would require labial bone graft and obliteration of incisive canal and bone graft on palatal aspect and good flap design. We discussed this in great detail with Mike Pikos and I at last weekend's Stnergy meeting in Orlando. Hope to see you in NYC in August. Regards Mo


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1st due Bone graft labial GBR or Small autogenous plate from Palate or Ramus and at the same time obliterate the Incisive canal and add bone chips. 2. Return to site 5 months later and place implant 3. Wait 4 months and restore with proper provisional for tissue molding. **** ADD CTG if needed


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Have Treatment for this http://sowjanyadental.com/


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The nasopalatine nerve has been sacrificed over the years for purposes of osteotomies and pathology with minimal morbidity. This is a good case to present because it represents a challenge that we all encounter from time to time. Since esthetics are paramount in this area, the ability to safely obliterate the incisive canal is an option that we should keep on the table. Here is a link to an article that you may find beneficial. Mike


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https://www.aegisdentalnetwork.com/cced/2012/02/obliteration-of-the-nasopalatine-canal-in-conjunction-with-horizontal-ridge-augmentation


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