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Immediate implant disasters
Posted on 09.25.2014 06:36 PM
By Howard Gluckman
In Failures
A patient had a motor vehicle accident and as a result fractured both the front teeth below the gum. We extracted the centrals and placed the large diameter implants which was the rule at the time the year 2000. The custom abutments show the way they support the papilla and prevent the collapse of the elastin fibres. The final result is a good one. But................................................
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21 Comments
Charles Schwimer says on 09.25.2014 06:49 PM
Howie. GREAT SAVE! Fortunately you were wise from the start to place your implant platforms deep enough for your solution. Gotta love AUTOGENOUS TISSUE AND ZIRCONIA abutments. Well done. Best regards. Chuck
Juan Alberto Ruiz says on 09.27.2014 11:00 AM
Nice Case, we learn from ourselves, more from mistakes, but this is not one, i consider a total success. Congratulations.
Howard Gluckman says on 09.27.2014 11:06 AM
Thanks Juan. In hind site we could have done things very differently but at the time this was right.
ashok gowda says on 09.29.2014 10:17 PM
Great save Dr.Howard, thanks for sharing.
Carlos Ramirez says on 09.30.2014 01:14 AM
Jorge Campos says on 09.30.2014 04:08 AM
Howard, congratulations! This was very difficult to solve...without proper actions.
Was the CTG more thick than normal?
What would you do today if you have to solve this situation? Would you manage on the same way, same flap design?
Thanks for sharing your experience!
Jorge
Howard Gluckman says on 09.30.2014 12:08 PM
Thanks Jorge. The tissue is the normal width about 2mm in thickness. And the answer to your second question is definitely yes I would do it totally differently if I did it now. The vista that I did first to thicken the tissue before I raised the flap would be the same however the second procedure would be a tunnel or a second vista flap. I would not leave the epithelium on the CT either. This way we would get a fare superior soft tissue healing without any scarring like we have in this case. thanks for your great questions
tural ismayilov says on 10.22.2014 04:33 AM
Dear Howard my congratulation.,but you have not used any graft materials in this situation???
Howard Gluckman says on 10.22.2014 07:28 AM
Hi Tural do you mean graft material for bone grating over the buccal of the implants. If so I do not think you would get anybone growing here as it is outside the envelope as well as being agains the old implants so there is dead surface and no space for blood supply to the bone.
Xavier Uriarte says on 11.02.2014 05:46 PM
Great save, thank god for thick biotype and switch platform.
Thanks for sharing!
Maurice Salama says on 01.03.2015 07:05 PM
Remarkable and shows the IMPORTANCE of TISSUE THICKNESS!! regards Mo
Mark Bishara says on 10.17.2015 11:45 AM
what does CRF mean?
Howard Gluckman says on 01.31.2017 04:34 AM
Coronally repositioned flap
Carl Choi says on 01.26.2017 04:32 PM
What did you place under the vista flap? Palatal tissue?
Howard Gluckman says on 01.31.2017 04:34 AM
Yes they both got palatal tissue
Lotta Carmelo860 says on 07.01.2018 12:02 PM
Some riflection at today time ...... with the experience e knowledge.
pre: the laser frenulectomy has been wonderfull idea...
1-great save
2- the implant diameter is a little bigger for a post ex in the estetic zone
3- today a protection for the loss of bondle bone is obbliged... tissue connective graft or allogenic graft, or togheter
Dr Lotta - Padova
Howard Gluckman says on 07.03.2018 03:59 AM
agreed a lot wass learned here. This was done in 2000. This is what we thought we knew at the time
Emilio Rodriguez-Fernández says on 07.02.2018 10:55 AM
Nice case!!! Predictability! too many people forgot this word. Treatments should be predictable.
Howard Gluckman says on 07.03.2018 04:00 AM
totally agree Emilio. WE see the one case that works. Techniques need to work in every case.
Jaon Quartano says on 03.12.2019 04:46 AM
Thanks for share this case, Congratulations.
Howard Gluckman says on 04.01.2019 08:31 AM
thanks