what would you do

68 Rating(s).


Posted on By Juan Alberto Ruiz In Practice Management

Healthy woman aged 81. Failed bridge after more than 30 years.
canine root fracture and bone loss in lateral incisor.

OPT before treatment
root fracture

preop cbct
Preop oclusal view


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9 Comments

Expansion? Keep the lateral incisor? How is bone on distal of lateral? Molar buccal furcation? Nice case. thanks for sharing Dr. Salama


Reply

Jaun Alberto. Implant 12 and 13 and cantilever 11pontic. She is 81 right? Chuck


Reply

I really enjoy all the surgical cases on Xp, but do not do it myself. I myself enjoy endodontics.
I am noticing on the second picture there is a radio-opaque area in the root area where tooth number #14 use to be and in picture #4 I can see the some tooth structure that was probably left behind during previous surgery. From a dentist with minimal surgical background&skills will this affect future treatment? Will it be removed/is it removed already?


Reply

Thank you, in relation to the root i will leave it there, for sure Without any problem.


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Reply

I could think about 2 choices.

First, place an implant in the canine area, anchored apically, and do a tent augmentation with a titanium mesh. If it doesn't work, mesial cantilever as Chuck said.

Second, extract the lateral and place an implant there, then regenerate the defect between the lateral and the premolar.

Can't wait to see your solution.

Regards


Reply

The case is almost finished, i honestly think that my treatment option was correct. But i had a surprise, And not good, i will post it latter on.
Thanks all for your support.
Also one Good thing ,for me, it is usefull to improve my written english.
Sorry for my gramatical errors. You can Also correct then, jjjjjjj.



Reply

Alberto you show part of the solution!
1 Implant the two bicuspid area with 2 implants and a mesial cantilever with immediate load.
2 I would consider a bridge from first molar to lateral and central incisor and in 15 days is completely finished the case...
With no surgery. 6 months waiting for a GBR, a mesh...etc it´s a very long time at that age.
I do tend to think like this in old people cases.
Thanks for sharing
Jorge


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Jaun Alberto. Nice surgery. Perhaps could have used a longer implant for #11 to engaged more native bone? How did you manage the provisional? Interesting case. Hope to see more. Thank you for sharing. Chuck


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KLS Martin
NovaBone