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Advanced Root Resorption of Maxillary Central Incisors
Posted on 05.09.2019 01:50 PM
By Maurice Salama
In Implants
Management of Advanced Root Resorption of Maxillary Central Incisors. Patient desires esthetic result and wants ideal treatment. Left Central is mobile and has apical pathology. Right Central Incisor displays significant resorption but remains stable and without any perio or endo lesion. Choice made in 2013 to maintain Right Central Incisor and replace Left Central Incisor in a Staged approach. 5 year post op radiograph displayed. Thoughts and comments welcome. Dr. Salama
Simple Extraction of Right Central Incisor
PA pre-op
Ice Cream Cone Collagen membrane ala Dr. Tarnow
Sutures over bone graft
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9 Comments
Maurice Salama says on 05.09.2019 01:52 PM
Zr Abutment
Maurice Salama says on 05.09.2019 01:54 PM
Post op
Maurice Salama says on 05.09.2019 01:55 PM
Pa 5 years...still Right Central present and without mobility....
Gregory Mark says on 05.09.2019 05:53 PM
Interesting case! Do you think extracting #8 earlier would benefit to more bone preservation? Gregory
Maurice Salama says on 05.11.2019 08:34 AM
Gregory; When tooth resorbs it is the replacement is bone, so I do not believe we have less bone in #8 area. Most interestingly, to me, is that #8 after 5 years and severe resorption is still STABLE and supporting the restoration!! In addition, apparently the trauma caused a subcrestal fracture and the apical portion of the root was left behind and is still present without any pathology. regards and hope to see you at NYU in August. Maurice
Inas abuzneid says on 05.09.2019 07:01 PM
Is there shadow of lateral incisor below or supernumerary tooth..?
Gradual bone resorption by time around implant will affect stability of tooth #8
Maurice Salama says on 06.20.2019 02:04 PM
I disagree about "gradual bone resorption around implant will effect adjacent tooth"? This is 5 year post op and no apparent bone resorption around implant at all and complete health of overlying tissues. As for tooth over resorbed central, it is the apical portion of same tooth fractured at early age and still present without any pathology. Dr. S
Maziar Tavazoei says on 08.24.2019 07:43 AM
Great case and documentation as usual, and a lot to learn from as usual. What was the reason behind opting for socket preservation versus type II placement? Was there any specific advantage for that in management of this case?
When the time comes for replacing #8 (or 11 as we call it), what would you think would be your approach? Removing the retained root, or doing something like socket shield? Or even a cantilever crown off #9. Thank you, Maz
Ernest Erian says on 08.24.2019 10:34 AM
looks beautiful Dr Salama. Thanks for sharing