Ortho extrusion to increase bone in defect

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Posted on By bruce birchenough In Anterior/Esthetic

30 y.o. female presented with avulsed #24 asking for permanent replacement options. I believe #23 and 25 will need to be removed in some fashion and I am looking for options regarding implants and fixed bridgework. Would extrusion of 23,25 be of any benefit? Would PET of some fashion be applicable? Would submerging root #25 and PET #23/26 help retain hard and soft tissue for implant placement and longevity?

tooth #26

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Due to the significant labial plate loss (almost to basal bone), I'm not sure PET would offer any substantial benefit.
I see this case as probably either a) substantial vertical bone augmentation (orthodontic eruption first may help the augmentation but not substantially enough) then implants etc... or a more straight forward option b) two implant restored with prosthetic pink porcelain/resin. The direction for me would be guided by medical condition, smile line/lower lip, and patient preference once fully informed of the options.


Henry. I think the patient would be more inclined to go the conventional route. If that treatment plan is performed my main concerns were extractions of remaining incisors for placement of implants in positions 23/26 or 25 with a fixed bridge causing significant loss of hard and soft tissue therefore the thought of retaining some root structures?


Bruce; I agree with Henry, No Ortho or PET here will help as no labial bone on teeth and significant lack of KT on those teeth which is the greater challenge. For me, extractions and soft tissue augmentation first. Then new CBCT, and bone augmentation, then implant placement with artificial gingiva as needed. Good luck Mo


Maurice & Bruce, I also agree with henry over here PET is not required i think this a implant prosthesis case. The implants that provide support to the prosthesis as abutment sites. This is a restorative dental option for missing teeth